guide to ivf
Illustration by Alyssa Keifer

You’re about to start your in vitro fertilization (IVF) journey — or perhaps you’re already on it. But you’re not alone — about 1 in 8 women need this extra help in getting pregnant.

If you’re ready to start or add to your family and have tried all other fertility options, IVF is often the best way to have a biological baby.

IVF is a medical procedure in which an egg is fertilized with sperm, giving you an embryo — a baby seedling! This happens outside your body.

Then, the embryo is either frozen or transferred to your uterus (womb), which will hopefully result in pregnancy.

You may have several emotions as you prepare for, start, and complete an IVF cycle. Anxiety, sadness, and uncertainty are common. After all, IVF can take time, be physically demanding — and cost quite a bit — all for a chance at getting pregnant.

Not to mention the hormones. Around 2 weeks of regular shots can heighten your emotions and make your body feel completely out of whack.

It makes sense then, that the 30 days leading up to your IVF cycle are very important for ensuring your body is healthy, strong, and fully prepared for this fairly intense medical process.

This is your guide to giving yourself and your partner the best chance possible at having a baby through IVF. With this advice, you’ll not only get through your IVF cycle, but you’ll thrive throughout.

Prepare to surprise yourself with your own strength.

Going through an IVF cycle means going through several stages. It’s common to need more than one IVF cycle before things stick.

Here’s a breakdown of the stages, including how long each one takes:

Preparation

The prep stage begins 2 to 4 weeks before you start your IVF cycle. It includes making small lifestyle changes to make sure you’re at your healthiest.

Your doctor might recommend medications to get your menstrual cycle regular. This makes starting the rest of the IVF stages easier.

Stage 1

This stage takes just a day. Day 1 of your IVF is the first day of your period closest to the scheduled IVF treatment. Yes, starting your period is a good thing here!

Stage 2

This stage can take anywhere from 3 to 12 days. You’ll begin fertility drugs that stimulate, or wake up, your ovaries. This gets them revved up to release more eggs than normal.

Stage 3

You’ll have an injection of the “pregnancy hormone” or as it’s also known, human chorionic gonadotropin (hCG). This hormone helps your ovaries release some eggs.

Exactly 36 hours after the injection, you’ll be at the fertility clinic where your doctor will harvest or take out the eggs.

Stage 4

This stage takes a day and has two parts. Your partner (or a donor) will have already provided sperm or will do so while you’re having your eggs harvested.

Either way, the fresh eggs will be fertilized within hours. This is when you’ll begin taking a hormone called progesterone.

This hormone helps prepare your womb for a healthy pregnancy and reduces the chance of a miscarriage.

Stage 5

Less than a week after your eggs were harvested, your healthy embryo will be put back into your womb. This is a noninvasive procedure, and you won’t feel a thing.

Stage 6

At 9 to 12 days later, you’ll be back in your doctor’s office. Your doctor will give you a scan to check on how well your little seedling has made a home in your womb. You’ll also have a blood test to check your pregnancy hormone levels.

Below, we cover the lifestyle changes that’ll give your body the best support during your IVC cycle, pregnancy and for your general health.

What to eat during IVF

During an IVF cycle, focus on eating healthy, balanced meals. Don’t make any major or significant changes during this time, like going gluten-free if you weren’t already.

Dr. Aimee Eyvazzadeh, a reproductive endocrinologist, recommends a Mediterranean-style diet. Its plant-based, colorful foundation should provide the positive nutrition your body needs.

In fact, research shows that a Mediterranean diet may improve the IVF success rate among women who are under 35 years old and who don’t have overweight or obesity.

While the study was small, eating a healthy diet during the weeks leading up to the cycle certainly doesn’t hurt.

Since diet also affects sperm health, encourage your partner to stick to the Mediterranean diet with you.

Here are easy ways to revamp your nutrition with the Mediterranean diet:

  • Fill up on fresh fruits and vegetables.
  • Choose lean proteins, like fish and poultry.
  • Eat whole grains, like quinoa, farro, and whole grain pasta.
  • Add in legumes, including beans, chickpeas, and lentils.
  • Switch to low-fat dairy products.
  • Eat healthy fats, such as avocado, extra-virgin olive oil, nuts, and seeds.
  • Avoid red meat, sugar, refined grains, and other highly processed foods.
  • Cut out salt. Flavor food with herbs and spices instead.

How to work out during IVF

Many women avoid or stop exercising during their IVF cycle because they worry that hitting the mat might not be good for a potential pregnancy. Don’t worry. Most women can continue their exercise routine.

Dr. Eyvazzadeh recommends you keep doing what you’ve been doing, especially if you already have a consistent fitness regimen.

She advises that if you have a healthy body mass index (BMI), have been exercising, and have a healthy womb, you should keep exercising.

Eyvazzadeh does, however, recommend all women undergoing IVF keep their running to no more than 15 miles per week. Your knees will thank you also!

“Running is more disruptive to our fertility than any other form of exercise,” she says.

She explains that it can have negative effects on the thickening of the womb lining and shift blood away from the womb to other organs and muscles when the reproductive system needs it most.

If you’re an avid runner, safely replace your long runs with:

  • light jogging
  • hiking
  • the elliptical
  • spinning

Which products to toss and chemicals to avoid

Consider tossing or avoiding some household items made with endocrine-disrupting chemicals (EDCs).

EDCs interfere with:

  • hormones
  • reproductive health
  • prenatal development

Not to mention, they’re not good for your overall health.

The Endocrine Society has said these listed chemicals cause “significant concern to human health.” Dr. Eyvazzadeh recommends checking the products you use most and switching to more natural alternatives.

Chemicals to avoid and where they’re found

Formaldehyde

  • nail polish

Parabens, triclosan, and benzophenone

  • cosmetics
  • moisturizers
  • soap

BPA and other phenols

  • food-packaging materials

Brominated flame retardants

  • furniture
  • clothing
  • electronics
  • yoga mats

Perfluorinated compounds

  • stain-resistant materials
  • nonstick cooking tools

Dioxins

  • meat
  • dairy
  • art clay

Phthalates

  • plastic
  • medication coatings
  • cosmetics with fragrance

As you prepare to start your IVF cycle, tell your fertility doctor about any medications you take. Make sure to list everything, even the most ordinary drug, like:

  • a daily allergy pill
  • acetaminophen (Tylenol) or ibuprofen (Advil)
  • any prescriptions
  • over-the-counter (OTC) supplements

Some medications could potentially:

  • interfere with fertility drugs
  • cause hormonal imbalances
  • make IVF treatment less effective

The medications below are the most important to avoid. Ask your doctor if it’s possible to prescribe alternatives during your IVF cycle and even during pregnancy.

Medications to flag to your fertility doctor

There are a few natural supplements you can take to help support a new pregnancy.

Start a prenatal vitamin in the 30 days (or even several months) before your IVF cycle begins to increase your folic acid. This vitamin is critically important, as it protects against brain and spinal birth defects in developing fetuses.

Prenatal vitamins can even help your partner boost their sperm health.

Dr. Eyvazzadeh also recommends fish oil, which can support embryonic development.

If your vitamin D levels are low, start taking vitamin D supplements before your IVF cycle. Low levels of vitamin D in the mother may be linked to autism.

Remember that the Food and Drug Administration doesn’t regulate supplements for quality and purity like they do for drugs. Always review supplements with your doctor before you add them to your daily nutrition.

You can also check labels for an NSF International certification. This means the supplement has been certified as safe by leading, independent evaluation organizations.

Sleep and fertility are closely connected. Getting the right amount of sleep can support your IVF cycle.

A 2013 study found that the pregnancy rate for those who sleep 7 to 8 hours each night was significantly higher than those who slept for shorter or longer durations.

Dr. Eyvazzadeh notes that melatonin, a hormone that regulates both sleep and reproduction, peaks between 9 p.m. and midnight. This makes 10 p.m. to 11 p.m. the ideal time to fall asleep.

Here are a few ways to make healthy sleep part of your routine:

  • Cool your bedroom to 60 to 67ºF (15 to 19ºC), recommends the National Sleep Foundation.
  • Take a warm shower or soak in a hot bath just before bed.
  • Diffuse lavender in your bedroom (or use in the shower).
  • Avoid caffeine 4 to 6 hours before bedtime.
  • Stop eating 2 to 3 hours before bedtime.
  • Listen to soft, slow music to relax, like symphonic pieces.
  • Limit screen time for at least 30 minutes before bed. This includes phones, TVs, and computers.
  • Do gentle stretches before bedtime.

One of the great ironies of infertility is that there’s nothing straightforward or easy about the sex that should be responsible for making these babies!

In the 3 to 4 days before a sperm retrieval, men should avoid ejaculation, manually or vaginally, says Dr. Eyvazzadeh. She notes couples want the “whole pot full” of the very best sperm when it comes time to collect, as opposed to sourcing “what’s left” from a post-ejaculate sample.

That doesn’t mean total abstinence from sex, though. She says couples can engage in amorous contact, or what she likes to call “outercourse.” So, as long as the man isn’t ejaculating during that prime sperm development window, feel free to mess around.

She also recommends couples keep penetration shallow and avoid deep vaginal intercourse, as this can irritate the cervix.

You may want a drink after carrying the emotional burden of IVF. If so, there’s good news from Dr. Eyvazzadeh. She says it’s possible to drink in moderation.

But beware that a couple of drinks during the week could have negative effects on the outcome of the IVF cycle.

Also, you may not respond well to alcohol on top of the fertility drugs. It may leave you feeling miserable.

A 2011 study found that live birth rates were 21 percent lower in women who consumed more than four drinks in a week and 21 percent lower when both partners consumed more than four drinks in a week.

Of course, once you’ve completed the embryo transfer, you should abstain from drinking any alcohol at all.

As unpredictable as an IVF cycle can be, one thing’s a certainty: myriad physical symptoms.

Every woman and every cycle are different, so there’s no sure way to know which side effect you’ll experience on any given day of any given cycle.

Here are some ways to manage or even beat the side effects of fertility drugs.

Bleeding or spotting

  • Call your doctor immediately if bleeding or spotting occurs during the cycle.
  • Light bleeding or spotting after an egg retrieval is normal. Heavy bleeding is not.
  • Do not use tampons.

Dr. Eyvazzadeh advises her patients to “expect the worst period of their life after an IVF cycle, because the hormones used not only help the eggs to grow, but also thicken the lining.”

She cautions that this isn’t everyone’s experience, but if it’s yours, don’t worry and take pain medications as needed and per your doctor’s recommendations.

GI and digestive issues

There are plenty of OTC options available to treat digestive issues. Try taking:

  • Gas-X
  • a stool softener
  • Tums
  • Pepto-Bismol

Bloating

It may seem counterintuitive, but taking in more fluids can relieve bloating. If water is getting tiresome, hydrate yourself with:

  • coconut water
  • low-sugar electrolyte drinks or tablets
  • LiquidIV

Nausea

If natural remedies aren’t working, try an anti-nausea medication, such as:

But first, talk to your doctor to make sure OTC anti-nausea drugs are safe for you.

Headache and pain

Some OTC remedies for pain relief include:

  • acetaminophen (Tylenol)
  • ibuprofen (Motrin)
  • heating pads

Before taking any OTC drugs, talk to your doctor and ask about the best dosage for you.

Exhaustion and fatigue

  • Get 7 to 8 hours of sleep each night.
  • Try taking 30- to 45-minute naps during the day.
  • Don’t overcommit or overbook yourself. Take it easy (and say “no” whenever you want to!)

Stress and anxiety

  • Practice a slow, restorative breathing regimen.
  • Use the FertiCalm app for support and healthy ways to cope.
  • Use the Headspace app for meditation.
  • Practice yoga. Here’s our definitive guide.
  • Continue your exercise regimen.
  • Stick to any established routines and schedules.
  • Get plenty of sleep.
  • Take warm showers or baths.
  • Visit a therapist.
  • Have sex to release feel-good hormones.

Hot flashes

  • Wear light, breathable clothing.
  • Stay in air-conditioned spaces.
  • Add a fan to your bedside or desk.
  • Stay hydrated with cool water.
  • Avoid smoking, spicy foods, and caffeine.
  • Practice deep-breathing exercises.
  • Do low-impact exercises like swimming, walking, or yoga.

Preparing for and getting through IVF will likely be one of the most challenging experiences of your life.

There’s a lot to be said for mind over matter and making the most of uncomfortable, painful, and inconvenient situations. This is one of them.

Starting to take care of yourself early and often can be very helpful. Doing so will help you better manage, and even avoid, some of the pain points of an IVF cycle. Here are some tips:

  • Drink plenty of water.
  • Get plenty of sleep and treat yourself to naps.
  • Stock up on your favorite snacks.
  • Socialize with friends.
  • Go on a date with your partner.
  • Do yoga or other gentle exercises.
  • Meditate. Here are some how-to videos and poses to try.
  • Take a long, hot bath.
  • Get a massage.
  • Get a pedicure or manicure.
  • Read a book.
  • Take a vacation day.
  • Go to a movie.
  • Buy yourself flowers.
  • Journal and track your thoughts and feelings.
  • Get a haircut or blowout.
  • Have your makeup done.
  • Schedule a photo shoot to remember this time.

He may not carry the brunt of the IVF cycle, but your partner is an equally important cog in this wheel. Very soon, he’ll give the most important sperm sample of his life.

His diet, sleep patterns, and self-care are important, too. Here are five ways your male partner can support your IVF efforts and ensure you’re both in this together:

  • Drink less. A 2019 study found men who drank alcohol daily contributed to the reduced success of the cycle. Not smoking — weed or tobacco — helps, too.
  • Sleep more. Not getting enough sleep (at least 7 to 8 hours per night) can affect testosterone levels and sperm quality.
  • Avoid chemicals. A 2019 study showed that some chemicals and toxins also wreak havoc on hormones in men. This may lower sperm quality. Have your man toss harmful products and keep your home as toxin-free as possible.
  • Wear underwear… or don’t. A 2016 study found no significant difference in semen quality in the boxers versus briefs debate.
  • Eat well and exercise. A lower BMI and good overall nutrition can improve the quality of sperm collected during IVF.
  • Be supportive. The most important thing your partner can do is be there for you. Turn to them to talk, listen, snuggle, get help with shots, be proactive about pain medication, manage appointments, and pick up the slack. In short: Be the loving, supportive person you fell in love with.

Brandi Koskie is the founder of Banter Strategy, where she serves as a content strategist and health journalist for dynamic clients. She’s got a wanderlust spirit, believes in the power of kindness, and works and plays in the foothills of Denver with her family.