How do I prepare for IVF, and what should I ask?
The short answer
Use the three months before your first cycle: both of you stop smoking, and rule out a fluid-filled tube, a cavity problem and a high OHSS risk.
What to know
- Smokers need nearly twice as many IVF cycles to conceive. Both partners should quit.
- A hydrosalpinx (fluid-filled tube) roughly halves IVF success, and treating it first is recommended.
- Guidelines recommend transferring a single embryo in most cases.
- Most add-ons aren't shown to increase live births. The UK regulator rates PGT-A, ERA and immune treatments red.
- Ask for the all-in cost in writing, including what's refundable if a cycle is cancelled.
Read the full explanation
IVF is a big commitment of money, time and body. The months before your first cycle are one of the few stretches where what you do can still change the odds — and the questions you ask now shape the whole plan.
The three months before
- Strong evidence Both of you: stop smoking. Smokers need nearly twice as many IVF cycles to conceive, and miscarriage risk is higher. Secondhand smoke counts too.
- Moderate evidence Both of you: keep alcohol low. Four or more drinks a week was linked to lower live birth rates, and the effect was bigger when both partners drank. For men, more than about six drinks a week was linked to lower success.
- Emerging evidence CoQ10, if your egg reserve is low. The best-known trial used 600 mg a day for 60 days before IVF and found more eggs and better embryos, though not clearly more births. Details and cautions.
- Keep taking your prenatal, and make sure your partner is on track too — what actually helps sperm.
- Limited or mixed Weight. A higher BMI lowers IVF success, but trials of losing weight before IVF haven't increased live births, and delaying treatment can cost more than it gains if you're older. Ask how your doctor weighs it for you.
- Caffeine doesn't appear to affect IVF results. Staying under about 200 mg a day still matters once you're pregnant.
Things to rule out first
- Strong evidence A blocked, fluid-filled tube (hydrosalpinx). It roughly halves IVF success, and removing or blocking the tube beforehand is recommended. Ask whether your tubes have been checked.
- Strong evidence The uterine cavity. An ultrasound or saline sonogram to check for polyps, fibroids or a septum is standard. Routine hysteroscopy after a normal scan hasn't been shown to improve results.
- Strong evidence Your risk of OHSS (ovarian hyperstimulation syndrome), especially with PCOS or a high AMH. Ask what the clinic does to prevent it — the protocol, the trigger shot, and freezing embryos rather than transferring fresh.
About the plan
- Strong evidence How many embryos to transfer. Guidelines recommend a single embryo in most cases, and always one if it's been tested as chromosomally normal.
- Protocol, fresh or frozen transfer, ICSI, and what would cancel a cycle — ask why each is right for you.
- What the plan is if this cycle doesn't work.
Add-ons: ask for the evidence
Clinics often offer extras at extra cost. The UK fertility regulator (HFEA) rates each one, and most don't have good evidence of increasing live births.
| Add-on | UK regulator rating |
|---|---|
| Endometrial scratch, embryo glue, freeze-all for everyone | Yellow — conflicting evidence |
| Assisted hatching, intralipids | Grey — not enough evidence to rate |
| Time-lapse imaging, PICSI | Black — no effect on live birth |
| PGT-A, endometrial receptivity testing (ERA), steroids, IVIG, PRP | Red — not shown to work |
Ratings as published by the HFEA in September 2026; check the current list.
About money
- The all-in cost of one cycle: medication, monitoring, retrieval, lab, transfer, freezing and storage.
- What's refundable if a cycle is cancelled before retrieval, and after.
- Whether your clinic's financial team can check your coverage before you commit.
Look after yourself
Ask what counselling or support your clinic offers — European guidelines recommend psychological support as a routine part of fertility care. What helps, and what doesn't.
What the research shows
Ratings sit beside each point inside Read the full explanation, because this page covers several things and the evidence behind them differs.
Questions for your doctor
Edit any of these before you add it — they're yours. Your list stays in this browser, and you can print a one-page sheet from it.
- Why IVF now, and what about my results points to it?
- Is there anything I or my partner should do in the next three months to prepare?
- What protocol are you recommending for me, and why?
- What are your success rates for my age and diagnosis, per retrieval and per transfer?
- Fresh or frozen transfer, and how many embryos would you transfer?
- What is the all-in cost of one cycle, and what's refundable if it's cancelled before retrieval?
- Which add-ons are you recommending, what do they cost, and what's the evidence for each?
Sources
- ASRM, Tobacco or marijuana use and infertility: a committee opinion
- Rossi et al., Alcohol use and IVF outcomes in 2,545 couples, Obstetrics & Gynecology 2011
- Rao et al., Alcohol, caffeine and IVF outcomes: systematic review and meta-analysis, 2022
- Xu et al., CoQ10 before IVF in women with low ovarian reserve: randomized trial, Reproductive Biology and Endocrinology 2018
- ASRM, Obesity and reproduction: a committee opinion (2021)
- ASRM, Role of tubal surgery in the era of IVF: a committee opinion (2021)
- Smit et al., Hysteroscopy before IVF (inSIGHT randomized trial), The Lancet 2016
- ASRM, Prevention of moderate and severe ovarian hyperstimulation syndrome: a guideline
- ASRM, Guidance on the limits to the number of embryos to transfer (2021)
- HFEA (UK fertility regulator), Treatment add-ons with limited evidence
- ESHRE Guideline, Routine psychosocial care in infertility and medically assisted reproduction
- CDC, ART Success Rates (clinic data)
- SART, Find a clinic and success rates
Editorial status. Written and edited September 2026 · every citation on this page opened and checked against the claim it supports, September 2026 · not reviewed by a clinician. We say that plainly because it matters: this is researched and sourced writing, not a medically reviewed publication. Take it to someone who knows your history.
Onward Babe is educational, not medical advice. Everything here is built from published research and professional guidelines so you can have a better conversation with the doctor who actually knows your situation.