IVF: The Complete Guide to In Vitro Fertilisation

IVF: The Complete Guide to In Vitro Fertilisation | FertilitysIVF: The Complete Guide to In Vitro Fertilisation

Quick answer: Nobody sits in a fertility clinic thinking "I always imagined I'd be here." I certainly didn't. But IVF—in vitro fertilisation—has brought over 8 million babies into the world since 1978, and roughly one in 25 babies born in the UK today were conceived this way. It works by retrieving eggs, fertilising them with sperm in a laboratory, and transferring an embryo back to the uterus. This guide covers absolutely everything: the process, the costs, the emotional reality, and how to give yourself the best possible chance.

Key Takeaways

• IVF involves retrieving eggs, fertilising them in the lab, and transferring an embryo back to the uterus
• Success rates vary significantly by age: 35% per cycle under 35, dropping to 10% at 40-42
• Private IVF costs £4,890–7,377 per cycle in the UK; NHS funding covers roughly 27% of treatment
• Proper nutritional preparation for at least 3 months before starting improves egg quality and outcomes
• Frozen embryo transfer (FET) often has success rates equal to or better than fresh transfer

What Is IVF and Who Is It For?

When I first heard "IVF" mentioned in a consultation room, I felt my stomach drop. It sounded like a last resort—something for people who'd run out of options. But the more I learned (and believe me, I learned everything I could), the more I realised IVF isn't a last resort at all. It's a specific, well-understood medical process. In vitro fertilisation simply means creating an embryo outside the body—"in vitro" literally means "in glass"—rather than relying on conception to happen naturally in the fallopian tubes.

IVF is typically recommended for several situations:

• Blocked, damaged, or absent fallopian tubes
• Reduced egg quality or quantity (low AMH)
• Male factor infertility (low sperm count or motility)
• Unexplained infertility after investigation
• Endometriosis affecting fertility
• Previous failed intrauterine insemination (IUI)
• Preimplantation genetic testing (when medically indicated)

The numbers are worth noting: over 8 million babies have been born from IVF worldwide since that first success in 1978. In the UK alone, approximately one in 25 babies born today were conceived through IVF or another assisted reproductive technique. It's become routine. It's become trusted. And if you're reading this thinking "but I never imagined I'd need IVF"—I hear you. Nobody plans for it. But sometimes it's the right path, and understanding it properly takes away so much of the fear.

How Does IVF Work? The Process Step by Step

Understanding each stage helps you know what to expect physically, emotionally, and logistically. IVF isn't one moment—it's a cycle that typically takes 8–12 weeks from start to finish. I'm going to walk you through the entire IVF process because when I was first facing this, I couldn't find a single source that explained it all without either being patronisingly simple or terrifyingly clinical. You deserve better than that.

1. Initial Assessment and Baseline Tests

Before anything else, your clinic will do blood tests (hormone levels, AMH, FSH), an ultrasound to count your follicles, and possibly semen analysis if male factor is involved. This tells you and your clinic what you're working with. They'll also check for any infections, screen your uterus, and assess whether you're a good candidate for IVF at all.

2. Ovarian Stimulation (The "Stim" Phase)

This is where your IVF cycle officially begins. For 8–14 days, you'll inject yourself daily with gonadotropins (FSH and sometimes LH) to encourage your ovaries to produce multiple eggs instead of just the one that would naturally mature. These medications—like Gonal-f, Menopur, or Puregon—mimic your body's natural hormones but in higher doses.

You'll have regular blood tests and ultrasounds during this time to monitor how your follicles are growing. It's not a guessing game; your IVF clinic adjusts doses based on how you're responding. Some women sail through stim. Others feel bloated, emotional, or fatigued. I've spoken to women who said stim was the easiest part, and others who described it as two weeks of feeling like a different person. There's no "normal" here—just your experience. Be honest with yourself about how you're coping—and with your clinic.

3. Trigger Shot and Final Maturation

Once your follicles reach the right size (usually 16–20mm), you'll be given a "trigger" injection—typically human chorionic gonadotropin (hCG) or a GnRH agonist—that causes the eggs inside to finish their final maturation. This injection is timed precisely because egg retrieval happens 34–36 hours later. Miss the window and your eggs won't be ready; too late and they'll ovulate on their own.

4. Egg Retrieval Procedure

The egg retrieval is an outpatient procedure lasting about 15–20 minutes. You'll be sedated (not fully asleep, but deeply relaxed), and your doctor uses an ultrasound probe to guide a needle through the vaginal wall into each follicle, gently suctioning out the fluid and the egg inside. Most women retrieve between 8 and 15 eggs, though the range varies widely.

It's not usually painful, but you might feel pressure or mild discomfort. Afterwards, you'll feel a bit groggy and might have some light bleeding or spotting. Rest at home that day. You can't drive after sedation, so arrange someone to pick you up.

5. Semen Sample and Fertilisation

Your partner (or donor) provides a fresh semen sample on the day of egg retrieval. The embryologist will assess sperm quality: count, motility, and morphology. Then comes the choice between conventional IVF and ICSI.

Conventional IVF: Your eggs and sperm are placed together in a dish, and fertilisation happens naturally. The sperm finds the egg.

ICSI (Intracytoplasmic Sperm Injection): A single sperm is injected directly into each egg using a microscopic needle. This is used for male factor infertility (low count or poor motility) or if fertilisation failed in a previous cycle. ICSI fertilisation success ranges from 50–80% depending on sperm quality.

Your clinic will advise which is appropriate for you. Some use ICSI routinely; others reserve it for specific indications.

6. Embryo Culture and Development

Over the next 5–7 days, the embryologist watches your embryos grow. After fertilisation, the embryo should divide normally: 2 cells at day 1, 4 cells at day 2, 8 cells at day 3. By day 5, it becomes a blastocyst—a more complex structure with an inner cell mass (which becomes the baby) and an outer layer (which becomes the placenta).

Embryo culture conditions—temperature, oxygen levels, pH—are carefully controlled. Your clinic might use time-lapse incubators that photograph embryos every 10–15 minutes. However, the evidence that time-lapse improves outcomes is weak (it's classified as a BLACK traffic light by HFEA, meaning no proven benefit). Your embryos are fine in standard incubators too.

7. Embryo Transfer

By day 5, your doctor will assess which embryo (or embryos) to transfer. Most clinics now recommend single embryo transfer (SET) in younger women to avoid the risks of multiple pregnancy. Your embryologist will grade the embryo based on appearance: A, B, or C quality.

The transfer itself is simple and painless—it's like a cervical smear. Your doctor uses an ultrasound to guide a thin catheter through your cervix into your uterus, then releases the embryo. You'll lie still for 10–15 minutes, then go home. You can return to normal activity immediately (though many people take the afternoon off for emotional reasons).

8. Progesterone Support (Luteal Phase Support)

After transfer, you'll take progesterone—by injection, pessary, or gel—to support the developing embryo and prevent your womb lining from shedding. You'll continue this for at least 10–14 days (or longer if you get a positive test). Progesterone can make you feel tired, bloated, and emotional, but these side effects are temporary.

9. The Two-Week Wait

The time between embryo transfer and your pregnancy test is perhaps the most psychologically intense part of IVF. I'm not exaggerating when I say the two-week wait nearly broke me. You'll analyse every twinge, every cramp, every wave of nausea. Does this mean it worked? Or is it just the progesterone? You'll Google "IVF symptoms 5dp5dt" at 2am. You'll convince yourself it's worked. Then you'll convince yourself it hasn't. Then you'll feel guilty for thinking negatively. The mental gymnastics are relentless.

Here's what I wish someone had told me: the progesterone you're taking causes almost all the same symptoms as early pregnancy. So symptom-spotting is genuinely meaningless at this stage. The only thing that tells you the truth is the blood test. Try to hold onto that—even when your brain is screaming otherwise.

A blood test 10–12 days after transfer will check your beta-hCG level. A positive result (usually above 5 mIU/mL) means a pregnancy has started. A second blood test 48 hours later checks whether hCG is doubling, which is a good sign of a healthy, progressing pregnancy.

IVF Success Rates: What the Evidence Actually Shows

This is the question everyone asks first, and I understand why—it's the question I asked too. When my AMH came back at around 3 at age 32 (it should have been above 20), the first thing I wanted to know was: if we go down the IVF route, what are the actual IVF success rates? The honest answer is: it depends on your age, egg quality, and how many cycles you're willing to do.

The Human Fertilisation and Embryology Authority (HFEA) publishes detailed success rates. Per-cycle live birth rates in the UK (fresh embryo transfer) are:

• Under 35: ~35% per cycle, rising to 65%+ cumulative over 3 cycles
• 35–37: ~30% per cycle
• 38–40: 20–25% per cycle
• 40–42: ~10% per cycle
• 43+: ~5% per cycle

What's encouraging is the cumulative data. If you're willing to do multiple cycles, your chances improve significantly. One UK study found that 83% of women achieved a live birth by the 8th cycle—though most stopped much earlier because they succeeded or exhausted themselves emotionally and financially.

Several factors affect your personal success rate:

• Egg quality: Directly tied to age and AMH. Poor egg quality is the biggest barrier for women over 40
• Sperm quality: Male factor significantly reduces fertilisation rates in conventional IVF
• Uterine health: Fibroids, polyps, or scarring can reduce implantation
• Embryo quality: Grade A embryos have higher implantation rates than Grade B or C
• BMI: Extreme obesity or underweight can slightly reduce success
• Smoking and alcohol: Both reduce egg quality and implantation rates
• Clinic quality: Accreditation, experience, and live birth rates vary between clinics

Also worth knowing: frozen embryo transfer (FET) often has success rates equal to or slightly better than fresh transfer. This surprises people, but the data from high-quality studies like the JAMA freeze-all trial supports it.

How Much Does IVF Cost?

Let's talk about the thing nobody wants to talk about but everyone needs to know: money. IVF costs are significant, and the cost picture in the UK is fragmented between NHS and private care. When Tim and I were looking at egg freezing quotes—£5,000–7,000 per cycle, probably needing three cycles—it felt like the universe was adding financial cruelty to emotional cruelty. I know that feeling. So let me give you the real numbers.

Private IVF Costs

Private IVF treatment cycles cost between £4,890 and £7,377 per cycle (including medications). This breaks down roughly as:

• Consultation and baseline tests: £300–600
• Stimulation medications: £1,200–2,500
• Egg retrieval and lab work: £2,000–3,000
• Embryo transfer: £500–800
• Additional procedures (ICSI, freezing, etc.): £500–1,500

Most clinics also charge an annual "storage fee" for frozen embryos (roughly £100–300/year). Add-ons—like PGT-A genetic testing (£500–1,500 per cycle) or endometrial receptivity analysis (ERA, £600–1,000)—increase costs further.

NHS IVF Funding

The National Health Service does fund IVF, but only for about 27% of all cycles in the UK. This isn't because the NHS doesn't want to; it's because local integrated care boards (ICBs) set their own funding criteria within NICE guidelines.

NICE recommends:

• Three IVF cycles for women under 40
• One IVF cycle for women aged 40–42 (if they meet other criteria)
• No funding for women over 42

But "NICE recommends" doesn't mean your local ICB actually funds it. Waiting lists can be 6–18 months. Eligibility criteria vary wildly. Some ICBs demand you've been trying to conceive for 3 years; others say 2. Some require your BMI to be under 30; others under 32. It's the postcode lottery in action, and it's genuinely unjust.

If you're funded, your NHS cycle is free. Medications might be free (depending on your health authority), or you might pay a small contribution. The NHS rarely funds add-ons like ICSI or PGT-A unless there's a strong medical reason.

NHS-Funded IVF: Who Qualifies?

To be eligible for NHS IVF under current NICE guidelines (CG156 and NG257), you typically need to meet these criteria:

• Both partners aged 18–55 (specific to your ICB)
• Unexplained, primary infertility, or a diagnosed condition requiring IVF
• Normal BMI (usually 19–30, though this varies by ICB)
• Evidence you've been trying to conceive for 2–3 years (or shorter if there's a specific diagnosis like azoospermia)
• No living children from this or any previous relationship (in most ICBs)

The postcode lottery is real. Check your local ICB's fertility commissioning policy on their website—they usually publish it. Or contact a patient advocate like Fertility Network UK, who can help decode your local criteria.

IVF Medications: What to Expect

The sheer number of medications involved in IVF can feel overwhelming—I remember staring at a kitchen counter covered in boxes, syringes, and little glass vials thinking "how has my life come to this?" But once you understand what each one does, it stops feeling so chaotic and starts feeling like a plan. Here's what you'll likely be prescribed and why.

Gonadotropins (FSH and LH)

These are the main medications during ovarian stimulation. Recombinant FSH (follicle-stimulating hormone) like Gonal-f or Puregon stimulates your follicles to grow. Some protocols also include LH (luteinising hormone) in formulations like Menopur.

How it's given: Daily subcutaneous injections for 8–14 days.

Side effects: Bloating, mild abdominal discomfort, headaches, mood swings, mild weight gain (usually 2–5 pounds, mostly fluid). Rarely, ovarian hyperstimulation syndrome (OHSS, see below).

GnRH Agonists and Antagonists

These medications prevent your body from ovulating too early—which would ruin the cycle by releasing your eggs before they're retrieved.

GnRH agonists (leuprolide, buserelin): Suppress FSH and LH completely. Usually started in the cycle before IVF to "downregulate" your pituitary, then continued into the stim phase. Some protocols use a "short protocol" starting them mid-cycle.

GnRH antagonists (ganirelix, cetrorelix): Work faster and only need to be started once your follicles reach a certain size. Less suppression overall, fewer side effects. Increasingly preferred in modern protocols.

Side effects: Hot flushes, headaches, mood swings, joint aches. These are usually mild and resolve quickly after you stop the medication.

Trigger Injection (hCG or GnRH Agonist)

This final injection causes your eggs to finish their final nuclear maturation, preparing them for retrieval.

How it's given: One intramuscular or subcutaneous injection, exactly 34–36 hours before egg retrieval.

Side effects: Mild cramping, bloating, nausea. Some clinics offer a choice between hCG (cheaper, longer acting) and GnRH agonist (newer, may reduce OHSS risk slightly).

Progesterone (Luteal Phase Support)

After embryo transfer, you'll use progesterone to thicken your womb lining and prevent your period, supporting early pregnancy.

How it's given: Vaginal pessaries (Crinone, Cyclogest), injection (progesterone in oil), or oral micronised progesterone (Utrogestan).

Side effects: Fatigue, bloating, breast tenderness, mood swings, watery discharge (if using pessaries). These are mostly tolerable for 10–14 days. The pessaries are not glamorous—I'll leave it at that—but they do their job.

Risks and Side Effects of IVF

I don't want to scare you with this section, but I'd rather you know the risks upfront than discover them mid-cycle when you're already stressed. Most IVF side effects are mild and temporary. A few are more serious but genuinely rare. Knowing what to watch for gives you power, not fear.

Ovarian Hyperstimulation Syndrome (OHSS)

OHSS is an exaggerated response to the hormone stimulation, where your ovaries become swollen and leak fluid into your abdomen.

Mild OHSS: Affects 30–33% of women. Symptoms include bloating, nausea, mild abdominal pain, and mild diarrhoea. Resolves on its own within a few days to a week.

Moderate OHSS: Affects 3–5% of women. More severe pain, nausea, and vomiting. Requires medical evaluation and close monitoring.

Severe OHSS: Rare (1% or less). Can involve rapid weight gain, severe pain, reduced urine output, shortness of breath, and blood clots. This is a medical emergency requiring hospitalisation.

Risk factors include young age, PCOS, lean build, high AMH, and having many follicles. Your clinic reduces OHSS risk by monitoring carefully and, if needed, using a GnRH agonist for the trigger instead of hCG. If you ever feel like something isn't right during stim—trust that instinct and call your clinic. They'd always rather hear from you than not.

Infection or Bleeding from Egg Retrieval

The needle used during egg retrieval occasionally nicks a blood vessel or introduces infection. These complications are rare (less than 1%) and usually minor, but infection can occasionally require antibiotics or hospitalisation.

Multiple Pregnancy

Transferring two or more embryos increases the risk of twins or higher multiples. I know—twins sound lovely when you've been struggling to conceive even one. But multiple pregnancies carry genuinely higher risks of miscarriage, premature birth, and complications for both mother and babies. Most clinics now recommend single embryo transfer, and it's worth listening to them on this one.

Ectopic Pregnancy

Rarely, the embryo implants in the fallopian tube instead of the uterus. This requires immediate medical intervention (medication or surgery) because an ectopic pregnancy can't progress and risks rupture. Risk is slightly higher after IVF, possibly because of pre-existing tubal damage.

Emotional and Psychological Impact

This isn't usually listed in "medical risks," but honestly, for many people it's the hardest part of the entire IVF process. The hope, anticipation, and grief of IVF cycles—especially failed cycles—can be devastating. Research suggests the stress of infertility treatment can feel as intense as grieving a death or going through a divorce. It's also incredibly tough on your partner, who often feels helpless watching you go through the physical part while having no way to fix it.

Tim and I had to learn to set boundaries around "fertility talk"—we'd give ourselves 20 minutes in the evening to discuss it, then consciously switch to something else. Without that, IVF becomes the only conversation in your relationship, and it eats everything.

Anxiety, depression, and relationship strain are common and completely understandable. Many couples benefit from counselling before, during, or after treatment. Your IVF clinic should offer free counselling sessions; if not, seek it privately. I'd also recommend joining a support community—even just reading other people's experiences can make you feel less alone in this.

Frozen Embryo Transfer (FET): Your Second (or Third) Chance

If someone had told me five years ago that freezing an embryo and thawing it later would work just as well—sometimes better—than transferring it fresh, I wouldn't have believed them. It sounds counterintuitive. But the science has come a long way, and frozen embryo transfer is now one of the most reassuring parts of the IVF picture. Not all embryos are transferred fresh; some are frozen for future use, either because you want to preserve them for a second attempt, or because your clinic recommends it to reduce OHSS risk.

How FET Works

Your frozen embryos are thawed, assessed, and transferred into your uterus in a natural cycle or a medicated cycle (with oestrogen and progesterone). The process is simpler than fresh IVF: no injections, no egg retrieval, no fertilisation to worry about.

FET Success Rates

This is where frozen embryos surprise people. They work just as well as fresh—sometimes better. A major randomised trial (the JAMA freeze-all study) found that FET success rates matched or exceeded fresh transfer in women under 35. Why? Possibly because freezing allows time for better embryo selection, because the uterus is "fresher" without the hormone overstimulation, or simply because we're better at freezing and thawing than we used to be.

Embryo survival after thawing is excellent: 95–99% of embryos survive the thaw process with modern vitrification techniques.

Advantages of FET

• No stimulation medications needed (unless doing a medicated FET cycle)
• No egg retrieval procedure
• Potentially better success rates than fresh transfer
• Flexibility: freeze now, transfer later when you're ready
• Lower OHSS risk
• Cost-effective if you have multiple embryos (you don't pay for another cycle of stimulation)

IVF Add-Ons: What the Evidence Actually Says

This is where I get a bit ranty, because this is where clinics sometimes let people down. IVF add-ons are extra procedures or tests that clinics offer on top of standard treatment—often at significant extra cost—with claims they'll improve your chances. Some are backed by evidence. Many aren't. The HFEA publishes an annual review rating each one on a traffic light system, and I think every person considering IVF should read it before spending a penny on extras.

Add-Ons with BLACK Traffic Light (No Proven Benefit)

PGT-A (Preimplantation Genetic Testing for Aneuploidy): This tests embryos for chromosomal abnormalities before transfer. The idea seems logical—transfer only "normal" embryos—but the evidence doesn't support it for routine use. Studies show PGT-A doesn't improve live birth rates and may actually harm outcomes in some groups by reducing the number of available embryos. HFEA rates it BLACK. Unless you have a specific indication (recurrent miscarriage, advanced maternal age, prior chromosomal abnormality), skip it.

Time-Lapse Imaging: Incubators that photograph embryos every 10 minutes to predict which will develop best. Sounds sophisticated, but evidence of improved outcomes is lacking. Also BLACK.

Add-Ons with RED Traffic Light (Uncertain Evidence)

ERA (Endometrial Receptivity Array): Tests your endometrium to find the "window of implantation"—the exact time when your uterus is most receptive to an embryo. It's an intriguing test, but the evidence is mixed. Some studies show benefit; others show none. HFEA rates it RED (insufficient evidence). It costs £600–1,000 and requires a biopsy. Unless your clinic has a specific research protocol showing benefit in your situation, it's probably money better spent elsewhere.

Add-Ons Worth Considering

ICSI (if indicated by male factor): Not an add-on really, but a treatment choice. If male factor is present, ICSI improves fertilisation significantly.

Assisted Hatching: A laser or chemical treatment that thins the embryo's outer shell to potentially improve implantation. Evidence is modest but slightly positive. Many clinics include it routinely. Cost is usually £100–300.

How to Prepare for IVF: What I Wish I'd Known Sooner

This is where my voice matters most, because this is where clinics typically fail—and where I get properly fired up. They focus on the laboratory—the injections, the retrieval, the transfer—and largely ignore the foundation underneath: your egg quality, your uterine health, your nutritional reserves, and your mental resilience. When I sat in a consultant's office and was told "nutrition can't make any difference," I wanted to scream. Because the published research says otherwise. And my own story says otherwise.

When I was told at 32 that my AMH was around 3 (it should be above 20 for my age), I was devastated. Every clinic pushed egg freezing—£5,000–7,000 per cycle to preserve eggs that were, frankly, probably not very viable anyway. Instead, my partner Tim and I decided to build an evidence-based protocol. We had time before attempting IVF. We used it.

The Timeline: Start 3–6 Months Before IVF

Egg quality is determined by the environment in which eggs develop. Eggs are formed during fetal development, but their quality is shaped continuously by your metabolism, nutrition, oxidative stress, and inflammation over the months and years before ovulation. Most sources say start prepping 3 months before IVF. I recommend longer—6 months if possible, at least 3 months minimum. The investment compounds.

1. Mediterranean Diet as Your Foundation

If you do one thing to improve egg quality, make it this: adopt a Mediterranean dietary pattern. The evidence is strong. Women who follow a Mediterranean-style diet have better ovarian reserve, higher AMH levels, better egg quality, and improved IVF outcomes compared to women eating standard diets.

What does it look like? Emphasis on:

• Olive oil as your primary fat
• Abundance of vegetables (especially dark leafy greens, cruciferous vegetables)
• Whole grains and legumes (lentils, chickpeas, beans)
• Moderate fish (aim for 2–3 times weekly), especially fatty fish like sardines and mackerel for omega-3
• Nuts and seeds
• Moderate dairy (Greek yogurt, feta)
• Minimal processed food, refined carbs, and added sugar
• Minimal red and processed meat

This isn't a restrictive diet. It's abundant and delicious. And the research specifically links it to better fertility outcomes.

2. CoQ10 for Egg Quality

CoQ10 is a mitochondrial antioxidant. Your eggs are metabolically demanding—they need energy from thousands of mitochondria. CoQ10 supports mitochondrial function and reduces oxidative stress. Evidence shows women taking CoQ10 before IVF have improved egg quality markers and better outcomes.

I recommend 200–300mg daily of ubiquinol (the active form) for at least 2–3 months before starting IVF. Wild Nutrition's CoQ10 is my go-to—it's bioavailable and third-party tested. This is one supplement where the evidence genuinely supports supplementation.

3. Vitamin D

Low vitamin D is associated with poorer ovarian reserve, lower fertilisation rates, and lower implantation rates. In the UK, vitamin D deficiency is common, especially in winter months.

I recommend getting your level tested (optimal is 50–100 ng/mL for fertility). If you're low, supplement with 2,000–4,000 IU daily for at least 2–3 months. Once you're in the optimal range, maintenance dosing is usually 1,000–2,000 IU daily.

4. Omega-3 Fatty Acids

Omega-3s reduce inflammation and improve blood flow to reproductive organs. A small amount from food (fatty fish, flax, walnuts) is essential. Many women benefit from additional supplementation—aim for a combined EPA+DHA dose of 1,500–2,000mg daily.

5. Sleep and Circadian Rhythm

Sleep isn't glamorous, but it's non-negotiable for egg quality. During sleep, your body repairs cells and clears metabolic waste. Poor sleep increases cortisol, reduces egg quality, and impairs implantation.

Target 7–9 hours consistently. Keep your bedroom cool, dark, and quiet. Aim for consistent sleep and wake times, even on weekends. If you work late shifts or your sleep is chaotic, prioritise fixing that before starting IVF.

6. Stop High-Intensity Exercise (Temporarily)

I know this is counterintuitive. Exercise is healthy. But high-intensity interval training (HIIT) and very high-volume endurance exercise can increase cortisol and suppress reproductive hormones. During your prep phase and IVF cycle, dial back intensity.

Instead, focus on:

• Walking (30 minutes most days)
• Gentle yoga or pilates
• Swimming
• Moderate resistance training (not to failure)

You can resume HIIT after embryo transfer (with your doctor's clearance).

7. Stress Management and Breathwork

Chronic stress elevates cortisol, which interferes with reproductive hormones and egg development. You can't eliminate stress—IVF itself is stressful—but you can manage your nervous system response.

Practices that genuinely help: meditation, breathwork, therapy, acupuncture (some evidence supports it for fertility), and community support (IVF support groups help you feel less alone). Fertility anxiety is real, and addressing it isn't a luxury—it's part of your treatment.

8. Alcohol and Smoking

Both reduce egg quality and implantation rates. If you smoke, stopping is the single most impactful change you can make (beyond diet and sleep). Alcohol in moderation is probably fine, but heavy drinking reduces fertility. I'd suggest cutting back significantly or eliminating it during your prep phase.

9. Micronutrient Testing (Optional but Helpful)

A micronutrient panel (zinc, selenium, iron, B vitamins) can identify deficiencies that impair fertility. If you have a history of poor egg quality, malabsorption, or restrictive eating, consider testing and supplementing specific nutrients rather than guessing.

A Note for Partners: How to Actually Help

I asked Tim to tell me what he found hardest about our fertility journey, and he said something that stuck with me: "I felt useless. You were the one having the tests, the injections, the anxiety—and I couldn't do anything to fix it."

If you're the partner of someone going through IVF or preparing for it, here's what actually helps (because "just relax" is never the answer):

• Go to appointments with them. Even if you sit there quietly. Your presence matters more than you think
• Learn about the IVF process yourself—don't make them explain everything twice
• Ask "how are you feeling?" without trying to fix it. Sometimes they just need you to listen
• Take over the logistics you can control—cooking, admin, scheduling
• If male factor is involved, own your part: optimise your own fertility with the same commitment
• Set gentle boundaries together around how much you talk about IVF—it shouldn't consume every conversation
• Remember: you're allowed to feel scared and sad too. This isn't just happening to one of you

Dani Recommends: 4-7-8 Breathing for the Two-Week Wait

🌿 Dani recommends:

The two-week wait after embryo transfer is one of the most anxiety-inducing stretches I've ever experienced—and I hear the same from every client who's been through IVF. My go-to recommendation is 4-7-8 breathing: breathe in through your nose for 4 counts, hold for 7, and exhale slowly through your mouth for 8. Do three rounds before bed and again first thing in the morning. It activates your parasympathetic nervous system and genuinely helps bring your cortisol down. It won't change your result, but it will change how you experience the wait.

📋 Get all my recipes & resources →

The Bottom Line

IVF is a remarkable technology, and for many couples it's the path to parenthood. But it's not a magic solution, and it's not something you should rush into without proper preparation. The three months (or six, ideally) you spend optimising your nutrition, sleep, stress, and overall health before starting a cycle are just as important—arguably more important—than the technology itself.

Success with IVF isn't just about your age or AMH or the clinic you choose. It's about going in as healthy and prepared as possible. It's about choosing a clinic you trust and a team that listens. It's about managing expectations (success isn't guaranteed, and most cycles don't result in a baby). And it's about resilience—the willingness to try again if a cycle doesn't work, or to accept that IVF isn't your path and explore other options.

If you're considering IVF or are about to start your first IVF cycle, I want you to know: you're not broken. Your body isn't failing you. Sometimes getting pregnant requires medical help, and there's absolutely no shame in that. I spent months feeling like my body had betrayed me—until I realised it hadn't. It just needed support in a different way.

Take the time to prepare. Eat well. Move gently. Sleep properly. Manage your stress. Build your treatment plan around the whole of your health, not just the clinic appointments. And then, when you're ready, IVF can work. It has worked for over 8 million families worldwide. It might work for yours too.

Frequently Asked Questions

References

1. Human Fertilisation and Embryology Authority. (2024). Fertility Treatment 2022 Trends and Figures. HFEA.
2. National Institute for Health and Care Excellence. (2017). Fertility problems: assessment and treatment (CG156/NG156). NICE.
3. McLernon, D. J., Harrild, K., Bowman, N., et al. (2016). Cumulative live birth rates after one or more complete cycles of in vitro fertilisation: a population-based cohort study. BMJ, 355, i5735. doi: 10.1136/bmj.i5735
4. Dyer, S., Chambers, G. M., de Mouzon, J., et al. (2016). International Committee for Monitoring Assisted Reproductive Technologies (ICMART) World Report. Human Reproduction, 31(7), 1591–1625. doi: 10.1093/humrep/dew220
5. Human Fertilisation and Embryology Authority. (2024). Treatment Add-ons: Traffic Light System. HFEA.
6. Practice Committee of the American Society for Reproductive Medicine. (2023). Prevention and treatment of moderate and severe ovarian hyperstimulation syndrome. Fertility and Sterility, 119(6), 1007–1016. doi: 10.1016/j.fertnstert.2023.04.009
7. Roque, M., Haahr, T., Geber, S., et al. (2019). Fresh versus elective frozen embryo transfer in IVF/ICSI cycles: a systematic review and meta-analysis. Human Reproduction Update, 25(1), 2–14. doi: 10.1093/humupd/dmy033
8. Mastenbroek, S., Twisk, M., van der Veen, F., et al. (2011). Preimplantation genetic screening for aneuploidy of embryos after in vitro fertilisation in women aged 35 years or older: a systematic review and meta-analysis of randomised controlled trials. Human Reproduction Update, 17(4), 483–496. doi: 10.1093/humupd/dmr014
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