When you are mid-IVF, decisions about supplements can feel disproportionately heavy. You are doing the injections, going to the scans, managing the timeline, and somewhere on top of all that you are trying to work out whether the bottle of CoQ10 you started last month is helping, hurting, or doing nothing at all.
This guide is here to give you a clear, UK-focused answer. It is based on the most recent evidence-based reviews of IVF supplementation, the 2026 NICE fertility guideline (NG257), HFEA's position on add-ons, and routine NHS preconception advice. It walks you through which supplements have meaningful evidence behind them, which ones to pause before egg retrieval, what your male partner can usefully take, and how to bring all of this to your clinic in a way that gets you a real answer rather than a shrug.
- Routine NHS preconception advice (400µg folic acid daily; 10µg vitamin D daily year-round during pregnancy and preconception) applies to everyone going through IVF and is the only universally recommended supplement protocol.1,2
- The largest evidence-based review of IVF nutritional supplements (Hart 2024, Reproductive BioMedicine Online) concludes that for poor responders, starting CoQ10 and DHEA before a cycle may improve clinical pregnancy rates — but data on live birth remain limited.3
- The 2020 Cochrane review of antioxidants for female subfertility (63 trials, 7,760 women) found the evidence for any live-birth benefit was of very low quality — be cautious about strong claims either way.4 (Cochrane has since added an editorial note acknowledging that several included studies were later retracted; a full re-analysis is pending.)
- Several common supplements should be paused before egg retrieval: omega-3 and high-dose vitamin E (bleeding risk), St John's wort (interferes with stimulation drugs), and herbal hormone modulators such as chasteberry or DIM (may disrupt the protocol).5,6
- Your male partner's supplement window matters too: spermatogenesis plus epididymal transit takes around 64 days in stable-isotope studies (with some estimates spanning 64–90 days), so meaningful changes need at least two to three months before egg collection.7
- Always tell your fertility clinic exactly what you are taking — including doses — before stimulation starts.
What does the evidence actually say about supplements during IVF?
The honest answer is that for most supplements, the evidence is mixed and the highest-quality reviews urge caution. A 2024 evidence-based review by Hart in Reproductive BioMedicine Online examined DHEA, melatonin, CoQ10, carnitine, selenium, vitamin D, myo-inositol, omega-3, Chinese herbs, and dietary interventions for IVF outcomes. Its strongest single recommendation was a Mediterranean dietary pattern as your foundation, with selected supplements offering plausible benefits for specific subgroups (notably poor responders and women with PCOS).3
The 2020 Cochrane systematic review of antioxidants for female subfertility — the most comprehensive synthesis available, covering 63 trials and 7,760 women — concluded that the evidence on whether antioxidants improve live birth is of very low quality. You will see lab markers (mature oocytes retrieved, embryo grade) sometimes improve in trials, but a clean translation into more babies has not been shown.4 The European Society of Human Reproduction and Embryology (ESHRE) reflected this caution in its 2023 evidence-based recommendations on IVF add-ons by not endorsing routine CoQ10, melatonin, or NAC for the general IVF population.8
This does not mean supplements are useless. It means they sit in a "may help, unlikely to harm if taken sensibly, talk to your clinic" zone — not a "guaranteed boost" zone. The biggest single benefit usually comes from the things nobody wants to hear: a Mediterranean-style diet, sleep, stopping smoking, and getting weight into the BMI range your clinic recommends.3
Which supplements have the strongest IVF evidence?
A few supplements have enough signal in the literature to be worth discussing with your consultant. Here is how each one looks on the current evidence.
Folic acid (400µg daily).
This is the only supplement universally recommended for every woman trying to conceive in the UK, including those going through IVF. The NHS advises 400µg from at least three months before conception until the end of the first trimester. A higher 5mg dose is recommended in specific higher-risk situations — for example, if you have diabetes, a BMI of 30 or above, are taking certain medications such as antiepileptics, have coeliac disease, sickle cell disease or thalassaemia, or have had a previous pregnancy affected by a neural tube defect. Your GP or clinic will advise.1 Folic acid is in every reputable prenatal multivitamin and in FertilitySmart Conceive For Women.
Vitamin D (10µg daily for most adults).
The NHS recommends 10µg (400 IU) for everyone in autumn and winter, and year-round if you have darker skin or limited sun exposure. A 2024 systematic review and dose-response meta-analysis in Reproductive Sciences found a positive association between sufficient vitamin D status and clinical pregnancy rates in women undergoing IVF, with a clearer benefit visible for women whose vitamin D levels were low to start with.9 The implication is sensible: aim to have adequate vitamin D status before stimulation rather than mega-dosing during it.
CoQ10 (typical research dose 200–600mg daily, taken for two to three months pre-cycle).
CoQ10 supports mitochondrial energy production in the developing egg. The Hart 2024 review concludes that starting CoQ10 before cycle commencement is better than control therapies in poor responders, with several meta-analyses showing improved clinical pregnancy rates in this group.3 Florou and colleagues' 2020 meta-analysis (five RCTs, 449 women) reported more than double the clinical pregnancy rate with CoQ10 versus placebo or no treatment (28.8% vs 14.1%) in women undergoing assisted reproduction, with no significant difference in live birth — likely reflecting the small number of trials available.10 CoQ10 is most discussed for women over 35 and those with diminished ovarian reserve.
Melatonin (typical research dose 2–3mg at night).
Melatonin acts as an antioxidant inside the follicular fluid as well as a sleep regulator. The Hart 2024 review notes that some IVF outcomes (mature oocyte counts, embryo grade) appear to improve in trials, but the optimal dose and the patient group most likely to benefit are not yet clear.3 ESHRE 2023 did not recommend it as a routine add-on.8 If you are considering it, agree the timing and dose with your clinic — melatonin can interact with the hormonal stimulation protocol.
DHEA (typically 75mg daily, prescribed).
DHEA is reserved for women with diminished ovarian reserve and is initiated by a fertility consultant, not as a self-bought supplement. Hart 2024 reports a clinical pregnancy benefit when started before cycle commencement in poor responders.3 In the UK, the picture is more cautious than many patients realise: HFEA classifies androgen supplementation (which includes DHEA) as a treatment add-on and currently gives it a "grey" rating under its five-tier system, meaning the regulator does not yet have enough high-quality evidence to decide whether it improves treatment outcomes. A 2025 HFEA expert review of DHEA in poor responders and women with diminished ovarian reserve found no demonstrated impact on egg retrieval or live birth rates.11 So this is not a take-without-asking supplement, and the conversation with your clinic should include the current evidence picture as well as the dose.
Myo-inositol (typically 2g twice daily for women with PCOS).
For women with PCOS undergoing IVF, the Hart 2024 review found a probable benefit on cycle outcomes, although the optimal dose remains debated. Myo-inositol is one of the better-studied options for the PCOS subgroup specifically.3 If you are already taking Metformin for PCOS, mention myo-inositol to your clinic before starting — both improve insulin sensitivity through different pathways, and the combination is generally considered safe but benefits from clinical oversight.
Which supplements should you stop — and when?
This is the half of the conversation most articles skip. Some supplements that are perfectly sensible in normal preconception care become a problem once you start the stimulation protocol — either because they thin the blood (a problem for egg collection, which is a needle procedure), interfere with the stimulation drugs, or push hormones in unwanted directions.
The table below summarises the most common ones. It is a general guide — your clinic's specific protocol takes precedence.
| Supplement | Why it can be a problem during IVF | When to consider stopping | Evidence basis |
|---|---|---|---|
| Omega-3 / fish oil (high dose) | Mild theoretical antiplatelet effect; most clinics pause as a precaution around egg retrieval | At least 1–2 weeks before egg collection (clinic-precautionary) | Antiplatelet activity of high-dose marine omega-3 is well documented, although recent perioperative evidence suggests actual bleeding risk is small5 |
| Vitamin E (high dose, >400 IU) | Antiplatelet effect at higher doses; bleeding risk around retrieval | 2 weeks before egg collection | Well-documented at supratherapeutic doses5 |
| St John's wort | Strongly induces CYP3A4 liver enzymes; can lower levels of stimulation hormones and progesterone via the same mechanism documented for oral contraceptives | Before stimulation starts | Clinically significant CYP induction6 |
| Chasteberry (Vitex) | Acts on the pituitary; can interfere with stimulation protocol | Before stimulation starts | Hormonal action incompatible with controlled stimulation |
| DIM / I3C (diindolylmethane) | Modulates oestrogen metabolism; conflicts with high-oestrogen stimulation phase | Before stimulation starts | Hormonal modulation incompatible with protocol |
| Ginkgo / garlic supplements (high dose) | Antiplatelet effects; bleeding risk at retrieval | 1–2 weeks before egg collection | Documented antiplatelet activity5 |
| Retinol-containing supplements and cod liver oil | NHS preconception guidance is to avoid these during preconception and pregnancy because of teratogenic risk; UK regulatory bodies advise total vitamin A intakes above 700µg/day are not recommended | Before stimulation starts | NHS preconception guidance and NICE NG247 maternal nutrition guideline1,2 |
| Aspirin (low-dose, if self-prescribed) | Bleeding risk; only take if your clinic has prescribed it | Discuss timing with clinic | Clinic-led decision |
Two principles cover almost every situation. First, tell your clinic about everything you are taking — including "natural" or "herbal" products. Second, if in doubt, pause it during the active stimulation and retrieval window and resume after embryo transfer if your clinic agrees.
What should your male partner take?
Your partner's window is often the missed piece. Spermatogenesis plus epididymal transit takes around 64 days from the earliest precursor cell to a mature, motile sperm in stable-isotope studies — older estimates extend this range up to about 90 days. Either way, anything he does in the month before egg collection makes minimal difference to the cells used in that cycle. Meaningful supplement protocols on the male side need at least two to three months of lead time.7
The most recent Cochrane review of antioxidants for male subfertility (2022) meta-analysed 65 randomised controlled trials including 10,303 men and found low-certainty evidence that antioxidants may improve live birth (odds ratio 1.43) and clinical pregnancy rates (odds ratio 1.89) in couples like you undergoing assisted reproduction. The most studied combinations included vitamin E, vitamin C, zinc, selenium, CoQ10, L-carnitine, and folate.12
For your IVF preparation, a sensible male protocol typically includes a comprehensive antioxidant multi (or FertilitySmart Conceive For Men), zinc, selenium, and CoQ10, alongside lifestyle basics — stopping smoking, reducing alcohol, avoiding heat exposure (saunas, laptop on lap), and addressing weight if relevant. One note on selenium: it has a narrow therapeutic window, so make sure your partner stays within typical male-fertility doses (100–200µg/day) and does not exceed 400µg/day.
If you are a couple with known male-factor involvement — abnormal sperm count, motility, or DNA fragmentation — the lead time and supplement plan are worth discussing with your andrology team rather than self-directing.
How do you build a supplement plan that works with your clinic?
The practical answer is to come to your nurse or consultant with a written list. Most clinics will not volunteer the conversation, but every reputable clinic will engage with it if you bring it.
A useful approach is to put your list in three columns. Column one: what you are currently taking (name, dose, daily amount, how long you have been taking it). Column two: what you are considering adding (and why — for example, "CoQ10 because I am 38 and was told my AMH is low"). Column three: questions for your clinic — "Should I stop omega-3 before stimulation, and if so, when?", "Is there anything in your protocol I should pause?", "Is melatonin compatible with my trigger drug?".
This converts a vague "do you take any supplements" tick-box conversation into a specific clinical exchange. It also protects you. A 2025 mixed-methods analysis of an online IVF forum found that patients commonly turn to community forums for supplement advice — discussion of CoQ10 (ubiquinone), vitamin D, omega-3, DHEA, and myo-inositol came up across hundreds of posts, often without clear input from the patient's clinic.13 A written list closes that gap.
A few patterns work well. Start your changes at least three months before stimulation, not weeks before. Choose comprehensive prenatal multivitamins over stacking individual nutrients (less risk of accidentally doubling up). Avoid mega-doses on the basis that "more must be better" — they are the most likely to cause problems. And revisit your list at each stage: the right plan during pre-cycle prep is different from the right plan during stimulation, and different again during the two-week wait.
Frequently Asked Questions
Can I take fertility supplements during IVF?
For most fertility supplements that have been used in normal preconception care, yes — but you need to tell your clinic exactly what you are taking, and a few specific supplements (omega-3, high-dose vitamin E, St John's wort, chasteberry) should be paused at specific points in the cycle. The single most important rule is full disclosure to your clinic before stimulation starts.
Should I take CoQ10 during IVF?
Evidence is strongest for starting CoQ10 (typically 200–600mg daily) at least three months before a cycle in women who are poor responders or over 35. Starting it the week before stimulation will not have time to produce a measurable effect, since CoQ10 takes weeks to reach steady-state levels and the mitochondrial benefit unfolds over months. Discuss with your consultant.3,10
Is melatonin safe during IVF?
Some trials suggest small benefits to oocyte and embryo quality, but ESHRE 2023 did not recommend it as a routine add-on, and the optimal dose remains uncertain. If you want to try it, agree the dose, the timing, and whether to continue or stop at trigger with your clinic — melatonin can interact with the hormonal stimulation drugs.3,8
When should I stop fish oil before egg retrieval?
Most clinics advise pausing high-dose omega-3 / fish oil one to two weeks before egg collection as a precaution, on the basis of omega-3's mild antiplatelet activity at higher doses. Recent perioperative evidence suggests the actual bleeding risk in surgical settings is small, but the precautionary pause remains common UK clinic practice. A low maintenance dose may be acceptable — check with your clinic. Resume after retrieval if your clinic agrees.5
Should I take DHEA during IVF?
DHEA is reserved for women with diminished ovarian reserve and should only be started under a fertility consultant's supervision, not self-bought from a supplement shop. HFEA classifies androgen supplementation as a treatment add-on with a "grey" rating — meaning there is currently not enough high-quality evidence to determine whether it improves outcomes — so the decision needs to be made together with your clinic, with the evidence picture on the table.11
What supplements should my male partner take before IVF?
A typical two-to-three-month pre-cycle protocol for your partner includes a comprehensive antioxidant multi covering vitamin C, vitamin E, zinc, selenium, CoQ10, and L-carnitine, plus folate. The 2022 Cochrane evidence is low-certainty but suggestive of benefit, particularly where there is a known male-factor component.12 Lifestyle matters as much as supplements — stopping smoking, reducing alcohol, and avoiding heat exposure.
Will supplements increase my chance of a live birth from IVF?
The most rigorous reviews — including the 2020 Cochrane meta-analysis of antioxidants for female subfertility — conclude that current evidence for a meaningful live-birth benefit from any single supplement is of very low quality.4 If you are in a selected subgroup (poor responders, PCOS), you may see modest benefits with specific protocols, but no supplement currently has the level of evidence needed to be called a routine IVF booster.
Are FertilitySmart supplements safe to take during IVF?
The Conceive For Women and Conceive For Men formulas are designed for preconception use and contain folic acid, vitamin D, and other commonly recommended micronutrients. As with any supplement during IVF, share the full ingredient list with your clinic before starting stimulation so they can confirm there are no interactions with your specific protocol.
Supporting Your Fertility with FertilitySmart
Whether you are weeks or months from a cycle, having the foundational micronutrients in place is the part of supplement support that has the clearest evidence behind it — folic acid, vitamin D, and a sensible antioxidant base for both partners.
At FertilitySmart, we offer both fertility supplements for women and fertility supplements for men that contain the core nutrients discussed in this guide, including folate, vitamin D, zinc, selenium, and CoQ10. Explore our range of evidence-based fertility supplements formulated for your preconception window.
Related Reading
- The Complete Guide to Fertility Supplements for Women & Men
The pillar overview of supplement choices across the full fertility journey. - How to Improve Egg Quality Naturally
The three-month preparation window matters for IVF too. - What Does CoQ10 Do For Fertility?
Deep dive on the supplement most discussed in IVF contexts. - Does Folic Acid Help Fertility?
The NHS-recommended preconception nutrient. - Vitamin E for Fertility
Why high-dose vitamin E needs careful timing around egg retrieval. - Sperm DNA Fragmentation
When male factor changes the supplement plan. - L-Carnitine for Fertility
An antioxidant with most evidence on the male side. - Fertility Diet
The Mediterranean pattern that underlies most IVF nutrition advice. - Trying to Conceive at 35+
Why the IVF supplement conversation often starts here. - How to Boost Your Fertility in Your 40s
Supplement and lifestyle decisions specific to this stage.
References
- NHS. Vitamins, supplements and nutrition in pregnancy. NHS.uk. Updated 2024. nhs.uk/pregnancy/keeping-well/vitamins-supplements-and-nutrition
- National Institute for Health and Care Excellence. Fertility problems: assessment and treatment. NICE guideline NG257. London: NICE; 2026. nice.org.uk/guidance/ng257
- Hart RJ. Nutritional supplements and IVF: an evidence-based approach. Reproductive BioMedicine Online. 2024;48(3):103770. doi:10.1016/j.rbmo.2023.103770. pubmed.ncbi.nlm.nih.gov/38184959
- Showell MG, Mackenzie-Proctor R, Jordan V, Hart RJ. Antioxidants for female subfertility. Cochrane Database of Systematic Reviews. 2020;(8):CD007807. doi:10.1002/14651858.CD007807.pub4. cochranelibrary.com/CD007807.pub4
- Stanger MJ, Thompson LA, Young AJ, Lieberman HR. Anticoagulant activity of select dietary supplements. Nutrition Reviews. 2012;70(2):107-117. doi:10.1111/j.1753-4887.2011.00444.x. pubmed.ncbi.nlm.nih.gov/22300597
- Henderson L, Yue QY, Bergquist C, Gerden B, Arlett P. St John's wort (Hypericum perforatum): drug interactions and clinical outcomes. British Journal of Clinical Pharmacology. 2002;54(4):349-356. doi:10.1046/j.1365-2125.2002.01683.x. pubmed.ncbi.nlm.nih.gov/12392581
- Misell LM, Holochwost D, Boban D, et al. A stable isotope-mass spectrometric method for measuring human spermatogenesis kinetics in vivo. Journal of Urology. 2006;175(1):242-246. doi:10.1016/S0022-5347(05)00053-4. pubmed.ncbi.nlm.nih.gov/16406920
- ESHRE Add-ons Working Group; Lundin K, Bentzen JG, Bozdag G, et al. Good practice recommendations on add-ons in reproductive medicine. Human Reproduction. 2023;38(11):2062-2104. doi:10.1093/humrep/dead184. pubmed.ncbi.nlm.nih.gov/37747409
- Xu C, An X, Tang X, Yang Y, Deng Q, Kong Q, Hu Y, Yuan D. Association between vitamin D level and clinical outcomes of assisted reproductive treatment: a systematic review and dose-response meta-analysis. Reproductive Sciences. 2024. doi:10.1007/s43032-024-01578-9. link.springer.com/article/10.1007/s43032-024-01578-9
- Florou P, Anagnostis P, Theocharis P, Chourdakis M, Goulis DG. Does coenzyme Q10 supplementation improve fertility outcomes in women undergoing assisted reproductive technology procedures? A systematic review and meta-analysis of randomized-controlled trials. Journal of Assisted Reproduction and Genetics. 2020;37(10):2377-2387. doi:10.1007/s10815-020-01906-3. pubmed.ncbi.nlm.nih.gov/32767206
- Human Fertilisation and Embryology Authority. Androgen supplementation (treatment add-on). HFEA.gov.uk. Updated 2024. hfea.gov.uk/treatments/treatment-add-ons/androgen-supplementation
- de Ligny W, Smits RM, Mackenzie-Proctor R, Jordan V, Fleischer K, de Bruin JP, Showell MG. Antioxidants for male subfertility. Cochrane Database of Systematic Reviews. 2022;(5):CD007411. doi:10.1002/14651858.CD007411.pub5. cochranelibrary.com/CD007411.pub5
- Tomlinson AF, Chapalamadugu M, Hombal A, Rodriguez S, Patrizio P. Investigating perceptions and usage of fertility supplements: a mixed methods analysis of a large online forum. Journal of Assisted Reproduction and Genetics. 2025;42:3435-3442. doi:10.1007/s10815-025-03625-z. pmc.ncbi.nlm.nih.gov/articles/PMC12602756
Marina Carter
Fertility Health Expert at FertilitySmart
Marina Carter is the in-house Fertility Health Writer at FertilitySmart, where she translates the latest reproductive and nutritional science into clear, practical guidance for individuals and couples trying to conceive. Her work spans ovarian and sperm health, preconception nutrition, PCOS, and the evidence base for fertility supplementation. Read Full Bio →