The 90-Day IVF Prep: What Actually Moves the Needle (and What Doesn’t)

By Hilary Metcalfe

Three months might not sound like a long time. But in the world of IVF, it’s everything. The eggs collected in a treatment cycle don’t just appear on cue, they’ve been quietly developing for the past 90 days. Sperm, too, takes around 74 days to fully mature. Which means the choices you and your partner make in the three months before IVF can directly shape the quality of the cells you’ll bring to the table.

The problem? The internet is full of “IVF prep” advice, some of it helpful, much of it unproven, and plenty that feels overwhelming when you’re already managing the emotional weight of fertility treatment. What really matters? What’s just noise? And what are the simple, doable steps that make the biggest difference?

In this article, we dig into the science (pulling from fertility research, large-scale IVF outcome studies, and preconception health data) to map out the evidence-based levers you can actually control. From nutrition to sleep, supplements to stress, even environmental exposures like skincare and household products (yes, they matter), here’s how to make the 90-day window before IVF work in your favour.

Xx, Hilary
Co-Founder, The SABI

Why three months?

• Eggs & follicles: The cohort of follicles you’ll stimulate in your IVF cycle begins its final maturation ~2–3 months beforehand, what you do now influences the oocytes you’ll retrieve later.
  

• Sperm: A full cycle of spermatogenesis takes ~74 days; healthy changes today affect sperm quality by the time you start treatment.
  

In the UK, IVF outcomes are steadily improving: HFEA’s latest data show ~25% live birth per fresh embryo transferred across all ages (higher in younger groups), and ~35% per embryo for ages 18–34. That’s the baseline you’re trying to tilt in your favour. HFEA+1

The Big Levers

1) Diet: Mediterranean-leaning, not “perfect”

A Mediterranean-style pattern (veg, fruit, whole grains, legumes, fish/olive oil; minimal ultra-processed foods) is linked with better fertility markers and, in several cohorts, better ART outcomes. Mechanisms: improved insulin sensitivity, reduced inflammation, richer micronutrient density. Oxford Academic+3PubMed+3PubMed+3

How to do it (90 days):

• Aim for fish/seafood 2–3×/week, extra-virgin olive oil daily, 7+ veg/fruit  servings/day, prioritising small, short-lived oily fish such as sardines, anchovies, herring, and wild salmon. These provide DHA and EPA—key fatty acids for egg quality, sperm membrane integrity, and early embryo development—while carrying a much lower heavy-metal burden than larger predatory fish.Avoid frequent intake of large sport fish (e.g. tuna, swordfish, shark), which accumulate mercury and other heavy metals that can negatively affect reproductive outcomes.
• Front-load protein at breakfast; keep refined sugar as a treat, not a staple.

If you’re re-platforming your personal-care shelf to reduce endocrine-disruptor exposure, match that “cleaner inputs” mindset in the kitchen, whole ingredients, minimal plastics for storage, and glass/steel where you can.

2) Movement: consistent, moderate beats heroic

Pre-IVF physical activity is associated with higher clinical pregnancy and live-birth rates; extreme, sudden high-intensity bursts can be counter-productive if they create energy deficit. Target most days, moderate intensity (brisk walking, strength 2–3×/week). PMC+2PMC+2

3) Weight & metabolic health: helpful, within reason

Metabolic health is one of the most powerful, and modifiable, levers in the 90-day window.

Insulin sensitivity, blood sugar stability, inflammation levels and visceral fat all influence ovarian function, endometrial receptivity, sperm quality and embryo development. This is especially relevant in PCOS, where insulin resistance is present in up to 70% of cases and directly contributes to ovulatory dysfunction and poorer IVF outcomes.

Improving metabolic markers even within 8–12 weeks can:

• Improve ovulatory function in women with PCOS
• Improve oocyte quality and embryo development
• Improve sperm parameters in men
• Support a healthier uterine environment

There is strong evidence that better preconception glycaemic control is associated with improved implantation rates and reduced pregnancy complications. In women with insulin resistance and PCOS, improving insulin sensitivity (via diet, movement, and where appropriate myo-inositol) is associated with improved fertility outcomes and lower early pregnancy loss rates.PMC+2The ObG Project+2

4) Alcohol, smoking, caffeine: tidy up the “small hinges”

• Alcohol: Meta-analyses suggest paternal alcohol intake is associated with lower partner live-birth odds in IVF; evidence for maternal intake is mixed, with several studies signalling risk at higher intakes. A conservative, IVF-friendly stance is abstinence or near-zero for both partners during the 90-day window. The ObG Project+2Obstetrics & Gynecology+2

• Smoking/vaping: Smoking is consistently linked to worse ART outcomes (lower implantation; more meds; fewer oocytes). Quitting now matters for both partners. ASH+1

• Caffeine: There’s no strong evidence that moderate caffeine intake harms IVF outcomes directly. However, caffeine has well-documented effects on micronutrient depletion, particularly magnesium and B vitamins (including B6 and folate)—all of which are critical for stress regulation, hormone metabolism, methylation, and early embryonic development. Functional-medicine frameworks often aim for optimal, not merely “non-deficient,” levels of these nutrients during preconception. From that lens alone, reducing caffeine can meaningfully lower nutritional drain. A reasonable upper limit during IVF prep is 2–3 standard units per day (roughly ≤200 mg caffeine total), with many patients choosing to reduce further in the final weeks before stimulation.  The ObG Project 

5) Sleep & stress: under-rated, modifiable

Good-quality, regular sleep (aim 7–8 h, consistent bed/wake times) is associated with better completion of IVF cycles and, in several studies, better outcomes; structured mind-body/CBT programs can improve pregnancy rates and markedly reduce distress. Build sleep regularity and add one stress-regulating practice you’ll actually keep (brief breathwork, CBT-based tools, or guided mindfulness). Taylor & Francis Online+3PMC+3Nature+3

A wind-down ritual helps sleep latency, think a warm shower, Reviving Face Mist as a sensory cue, then a caffeine-free herbal cup (e.g., Calming Herbata) as part of your evening routine. It’s not a fertility treatment, but the ritual reliably signals “off-switch,” which your nervous system (and cycle) appreciate.

6) Endocrine-disrupting chemicals (EDCs): lower exposure where it’s easy

Several cohorts (e.g., EARTH) link phthalates, parabens, and BPA exposure with poorer oocyte metrics and IVF outcomes. You can’t eliminate EDCs from your world, but you can reduce them and remove them ASAP from your personal care products. Other places to focus on: avoid microwaving in plastic, choose fragrance-sensible products, ventilate well, and upgrade food storage. 

If you want to simplify your routine, SABI’s Active Nutrient Serum, Prebiotic Face & Body Cream, and Reviving Face Mist are all-natural, fragrance-from-botanicals (not synthetic perfume) and designed to be hormone-aware. That doesn’t mean “boosts IVF”—it means they’re built to be gentle on barrier, microbiome, and daily exposure load while your medical team handles the heavy lifting.

7) Supplements and diet: what’s consensus vs. what’s emerging

What’s widely recommended

• Folic acid 400 mcg/day: start now and continue through 12 weeks once pregnant (higher 5 mg dose for specific risk groups, ask your clinician). 

  Folate is non-negotiable in the 90-day IVF window—not only for women, but for men as well.

  • Women: 400 mcg/day minimum preconception and through 12 weeks of pregnancy (5 mg only for specific clinical indications, under medical guidance).

  • Men: Adequate folate status supports sperm DNA integrity, methylation, and chromosomal stability.

  Where possible, choose methylated folate (5-MTHF) rather than standard folic acid. Methylated forms bypass common conversion bottlenecks (e.g. MTHFR variants) and are more readily usable by the body for DNA synthesis and repair—key processes in both egg and sperm development.

  Optimising folate status is a shared responsibility in IVF prep: healthier sperm meaningfully improves fertilisation, embryo quality, and pregnancy outcomes. 

• Vitamin D 10 mcg (400 IU)/day: especially in the UK.
  These are public-health level recommendations (NHS/NICE/ACOG/CDC). nhs.uk+3nhs.uk+3nhs.uk+3

• Methylated B vitamins (B6, B9 [methyl-folate], B12): support healthy methylation pathways crucial for egg and sperm DNA integrity, hormone metabolism, and early neural development. Methylated forms are better absorbed and may benefit those with the MTHFR gene variant, who don’t convert standard folic acid efficiently.

• Vitamin D3 + K2 combination: Vitamin D3 helps regulate reproductive hormones and immune function, while K2 supports calcium transport to bones – important if taking higher-dose D to optimise egg quality, uterine health, and prevent arterial calcification.

Where evidence is promising but patient-specific

• Myo-inositol (± D-chiro-inositol) for PCOS-phenotypes: improves ovulatory function and oocyte maturity; often used pre-IVF in PCOS. Discuss dose and isomer ratio with your clinic.
  

• Coenzyme Q10 (CoQ10): meta-analyses in diminished ovarian reserve suggest better ovarian response and some improved IVF outcomes; not a blanket for everyone. PMC+1

For male partners

• Antioxidants for subfertile men show low-certainty benefit in older meta-analyses; a 2025 RCT found a combined antioxidant did not improve outcomes and possibly reduced ongoing pregnancies. Translation: don’t self-prescribe megadoses—get assessed first (including semen analysis per WHO 6th ed.). World Health Organization+3Cochrane+3PMC+3

While supplements are medical territory, your skincare and daily rituals are low-risk places to create consistency. A two-minute morning routine (Mist → Serum → Prebiotic Cream) is an easy “habit anchor” before you tackle needles, scans, and logistics.

8) Gut Health & Iron Status

Probiotics

Many IVF clinics recommend probiotics during stimulation. While evidence is still emerging, a healthy vaginal and gut microbiome appears to influence implantation and early pregnancy outcomes.³

If your clinic recommends one, use their protocol. Don’t self-stack multiple strains unnecessarily.

Iron Status

Adequate iron is essential before conception. Iron deficiency — even without anaemia — can impair ovulation, reduce oxygen delivery to developing follicles, and increase fatigue and stress load during IVF.

Ferritin levels should ideally be assessed before treatment.

Dietary sources:

Most bioavailable (heme iron):

• Grass-fed red meat

• Grass-fed beef liver (one of the most nutrient-dense preconception foods available)

• Lamb

• Sardines

An ancestral / whole-foods approach naturally supports iron, B12, choline and zinc — all critical for egg and sperm quality.

For plant-based women:

• Lentils

• Chickpeas

• Tofu / tempeh

• Pumpkin seeds

• Spinach

Pair plant iron with vitamin C to improve absorption. Be aware that plant (non-heme) iron is absorbed at significantly lower rates, so lab monitoring is especially important for vegans.

A 90-Day, Week-by-Week Skeleton

Weeks 1–2: Baseline & clean-up

If you have PCOS, this is the time to reduce your overall simple sugar intake and foods you know don't serve you so you can support your optimal metabolic health and insulin sensitivity, which will result in better TTC outcomes.

• Order: prenatal with 400 mcg folic acid (+ vitamin D 400 IU), Methylated B vitamins and D3 + K2.
  

• Replace plastic food containers used with heat; get a HEPA filter if feasible.
  

• Build a 20-minute movement block in your calendar 5×/week.
  

• Start a nightly wind-down (lights down, phone out, Mist → Serum → Cream, herbal cup).
  

• Partners: book WHO 6th-ed-style semen analysis if not done. nhs.uk+1  and start phasing out the worst offenders in your personal care products. Switch to clean, hormone-safe skincare, like our natural skincare range, and if you can’t find an all-natural perfume, consider taking a break from fragrance altogether. For laundry, choose an all-natural detergent without synthetic scent or harsh chemicals.

Weeks 3–6: Consistency phase

• Mediterranean meals 80% of the time; fish 2–3×/week.
  

• Alcohol: ideally zero for both partners; smoking: stop completely.
  

• Sleep: lights out ~same time nightly; aim for 7–8 h.
  

• If PCOS phenotype, discuss myo-inositol with your clinician now. Oxford Academic

Weeks 7–10: Personalisation

• If labs suggest DOR and your clinician agrees, consider CoQ10 trial; otherwise skip.
  

• Add 2 strength sessions/week (short counts).
  

• Track naproxen/ibuprofen avoidance as you near retrieval per clinic policy. PMC

Weeks 11–12: IVF logistics

• Finalise stimulation calendar; keep diet/sleep identical (don’t “reinvent” your routine mid-cycle).
  

• Keep stress tools bite-sized: CBT-style thought record, 4–7–8 breathing, 10-min guided mindfulness. Some mind–body/CBT programmes show higher pregnancy rates and better mental health in IVF. PMC+1

What to stop worrying about

• One “perfect” superfood: Patterns beat products or single ingredients.
  

• Punishing workouts launched out of nowhere: steady, moderate wins, especially for women with Endometriosis, PCOS, a history of trauma (physical or emotional), and any known anflammatory or autoimmune conditions (like thyroid issues), spiking cortisol through HIIT workouts for instance, can signal fight or flight mode in the body and negatively impact your condition and hormonal balance.
  

• Endless new supplements: Stick to folate + vitamin D, Methylated B vitamins and D3 + K2 by default; add others only with clinical rationale.

In three months you can meaningfully influence sleep regularity, diet quality, movement, environmental exposures, and partner factors, all without derailing your life. Layer in the non-negotiables (folate, vitamin D), personalise only where evidence supports it (myo-inositol for PCOS; CoQ10 for DOR with clinician sign-off), and keep your rituals simple and sustainable.

ABOUT HILARY  Hilary Metcalfe is a Certified Holistic Nutritionist, whole foods chef, and women’s health product developer whose work is grounded in both science and lived experience. Before co-founding The SABI, she worked in sustainability and corporate strategy—experience that now informs the brand’s commitment to ethical sourcing, transparency, and long-term impact. Her own journey through fertility challenges, miscarriage, Adenomyosis fuels her mission to help women reconnect with their cycles, understand their hormones, and feel truly supported in their bodies. At The SABI, Hilary leads product development, formulating OB-GYN-approved rituals and hormone-conscious skincare rooted in nutrition, herbal wisdom, and clinical insight. Originally from Los Angeles and raised in Baja California, she lives in Todos Santos, Mexico, with her husband Kees, rescue dog Flint, and their rainbow babies, Paloma and Bea.

HORMONAL & PROUD

Created as a brand to help women navigate the toughest moments in pregnancy, childbirth, postpartum — and practically every stage of life, the SABI aims to change the narrative around our hormones from one of taboo, embarrassment and loneliness, to awareness and even pride. Much more than a wellness brand, SABI offers a carefully crafted line of products to carry you through your hormonal journey; a set of rituals, supportive tools, and ancient herbal remedies that have been tested time and again by women and now, backed by medicine. SABI is a blend of science and nature conceived by women who have experienced the joys and deep implications of bringing a child into the world, the pains of a heavy and difficult period, miscarriage and difficulty conceiving

Here is an invitation to get to know your body and its cycles better and to really understand what is going on inside. Learn to use your hormonal cycle to your advantage no matter your stage of life, and know that you can always support and balance your hormone levels. Look for the right sources of information, know that there is help, and know that you’re supported.

DISCLAIMER

The SABI blog and articles are not meant to instruct or advise on medical or health conditions, but to inform. The information and opinions presented here do not substitute professional medical advice or consultations with healthcare professionals for your unique situation.

REFERENCES

• HFEA national outcomes & success rates. HFEA+1

• Spermatogenesis timeline (why 90 days matters). PMC+1

• Mediterranean diet & fertility/ART outcomes. PubMed+1

• Physical activity before IVF meta-analysis. PMC

• Weight-loss & preconception: mixed but often helpful, esp. metabolically. PMC+1

• Alcohol, smoking & IVF outcomes. The ObG Project+2Obstetrics & Gynecology+2

• Sleep quality/regularity & IVF completion/outcomes; mind-body/CBT effects. PMC+2Nature+2
  

• EDCs (phthalates/BPA/parabens) & IVF-related markers/outcomes. PubMed+1

• Myo-inositol for PCOS; CoQ10 for diminished ovarian reserve. Oxford Academic+1

• Folic acid & vitamin D in UK preconception guidance. nhs.uk+1