# Preparing for IVF: what you need to know > General information on the months before IVF: the tests usually done, folic acid and vitamin D, iron, smoking, alcohol, weight and activity, with sources. Source: https://www.ghinashami.com/en/guide/preparing-for-ivf/ Last updated: 2026-10-30 IVF guide The months before an IVF cycle are a good time to check your health and change what can be changed. Sperm take about three months to form, and several things that affect fertility, such as smoking and weight, can be improved before treatment starts. This guide summarises what international guidance advises. - 5 min read - Reviewed 13 October 2026 - 6 references ## Preparing alongside treatment planning Sperm take about three months to form, which is why changes such as stopping smoking are worth making well before a cycle. For women, folic acid is ideally started about three months before pregnancy. Preparation goes on at the same time as treatment planning. Female fertility declines with age, so your doctor will weigh the benefit of preparation against the time it takes. The [fertility tests](https://www.ghinashami.com/en/interests/fertility-tests/) page describes the assessment that usually comes before IVF. ## The tests before treatment Which tests are done depends on your history and on the clinic. Before IVF, guidance commonly includes: - **Blood tests for HIV, hepatitis B and hepatitis C** for both partners - **Rubella immunity** for women who are not sure they have been vaccinated, so that vaccination can be given before pregnancy - An up-to-date **cervical screening** test - **Chlamydia screening** before procedures that pass instruments through the cervix - A **semen analysis**, repeated if abnormal - **AMH or an antral follicle count**, to predict how the ovaries will respond to stimulation - For women with [PMOS](https://www.ghinashami.com/en/conditions/pmos-pcos/), an **oral glucose tolerance test** - Other blood tests where your history suggests them, such as a **full blood count** if anaemia is possible, or **thyroid function** if you have symptoms of thyroid disease Any problem found is usually dealt with before the cycle is scheduled. ## Folic acid, vitamin D and iron **Folic acid** is recommended for every woman planning a pregnancy, ideally from about three months before conceiving until 12 weeks of pregnancy. Some women need a higher dose; your doctor or pharmacist can tell you which applies to you. The NHS also advises taking **vitamin D** when trying to get pregnant. If a blood test shows **iron deficiency anaemia**, it is usually treated with iron tablets and iron-rich food. A course of tablets usually lasts about six months, and tablets can cause side effects such as stomach pain, constipation or feeling sick. If tablets do not suit you, your doctor can discuss alternatives. Other supplements are worth taking only when a test shows they are needed. NICE notes that the effectiveness of complementary therapies for fertility has not been properly evaluated, and ESHRE does not recommend adjuncts such as DHEA, growth hormone or testosterone before or during ovarian stimulation. ## Smoking, shisha and vaping Smoking is likely to reduce a woman's fertility, and passive smoking is likely to affect the chance of conceiving. In men, smoking is associated with reduced semen quality. Shisha and heated tobacco are forms of tobacco use too. The advice is for both partners to stop before treatment, with support if you need it. If you use e-cigarettes, ask your doctor about them. ## Alcohol and caffeine NICE advises women who are trying to become pregnant to avoid alcohol altogether, as the approach that carries the least risk. In men, heavy drinking harms semen quality, while drinking within recommended limits is unlikely to affect it. NICE found no consistent evidence linking caffeinated drinks with fertility problems; your doctor can advise on caffeine during treatment and pregnancy. ## Weight, food and physical activity A healthy weight helps. Women with a BMI of 30 or more are likely to take longer to conceive, and men with a BMI of 30 or more have a higher risk of reduced fertility. For women with a BMI under 18.5 and irregular or absent periods, gaining weight is likely to improve the chance of conceiving. NICE notes that a group programme combining exercise and dietary advice leads to more pregnancies than weight-loss advice alone. A balanced diet and regular physical activity help you reach and keep a healthy weight. They matter particularly with [PMOS](https://www.ghinashami.com/en/conditions/pmos-pcos/), where insulin resistance is common: the 2023 international guideline advises at least 150 minutes of moderate activity a week, plus muscle-strengthening activities on two non-consecutive days. Ask your clinic whether to reduce intense exercise once ovarian stimulation starts. ## Medicines and work Tell your doctor about every medicine and product you take, including prescription medicines, products bought without a prescription, herbal remedies and anabolic steroids, as some can affect fertility or pregnancy. Do not stop a prescribed medicine without advice. If your work involves exposure to chemicals or other hazards, mention it too. ## Questions worth asking your fertility clinic 1. **Which tests do we both need before the cycle?** And which of them, if any, have been done recently enough to count. 2. **Is anything worth correcting first?** For example anaemia, weight or smoking, and how long that is likely to take. 3. **Which medicines and supplements should I continue or stop?** Including the folic acid dose, vitamin D and anything bought without a prescription. 4. **How does my age affect the timing?** So that preparation and treatment can be timed together. Dr. Ghina Shami ## Common questions **How long before IVF should we stop smoking?** As early as possible, for both partners. Sperm take about three months to form, so stopping at least three months before treatment means the sperm used have developed without smoke exposure. Shisha and heated tobacco count as smoking. **Do I need iron treatment before IVF?** Only if a blood test shows you need it. Iron deficiency anaemia is usually treated with iron tablets for about six months; if tablets do not suit you, your doctor can discuss alternatives. **Which supplements should I take before IVF?** Folic acid, which every woman planning a pregnancy is advised to take, and vitamin D. Beyond that, only what a test shows you need. Bring everything you take, including herbal products, to your appointment: the effectiveness of complementary therapies for fertility has not been properly evaluated. **Can lifestyle changes replace IVF?** Stopping smoking, reaching a healthy weight and being active can improve the chance of conceiving and are worth doing in any case. Where IVF is needed, they complement it; they do not make it unnecessary. **Evidence basis:** This guide is based on the 2026 NICE fertility guideline, NHS patient information, the 2023 ESHRE recommendations on add-ons and the 2023 international PCOS guideline; much of the lifestyle advice rests on observational studies rather than trials, and the guide says where evidence is lacking. ## References 1. Fertility problems: assessment and treatment (NICE guideline NG257). NICE. 2026. Available from: [nice.org.uk/guidance/ng257](https://www.nice.org.uk/guidance/ng257). 2. Trying to get pregnant. NHS. 2026. Available from: [nhs.uk/pregnancy/trying-for-a-baby/planning-your-pregnancy](https://www.nhs.uk/pregnancy/trying-for-a-baby/planning-your-pregnancy/). 3. Folic acid: medicine used to keep your baby healthy in pregnancy and to treat folate deficiency anaemia. NHS. 2026. Available from: [nhs.uk/medicines/folic-acid](https://www.nhs.uk/medicines/folic-acid/). 4. Iron deficiency anaemia. NHS. 2024. Available from: [nhs.uk/conditions/iron-deficiency-anaemia](https://www.nhs.uk/conditions/iron-deficiency-anaemia/). 5. Good practice recommendations on add-ons in reproductive medicine. ESHRE, Human Reproduction. 2023. [doi:10.1093/humrep/dead184](https://doi.org/10.1093/humrep/dead184). 6. Recommendations from the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome. Human Reproduction (Teede et al.). 2023. [doi:10.1093/humrep/dead156](https://doi.org/10.1093/humrep/dead156). Written and reviewed by [Dr. Ghina Shami](https://www.ghinashami.com/en/about/), Consultant, Reproductive Medicine and Infertility · 13 October 2026 · [How these pages are prepared](https://www.ghinashami.com/en/legal/#accuracy)