Bottom line up front: The Mediterranean diet has the strongest evidence for improving IVF outcomes. CoQ10, vitamin D, and folate supplementation are well-supported. DHEA may help poor responders. Moderate exercise is beneficial; extreme exercise is not. Alcohol should be eliminated during treatment. Caffeine is acceptable in moderation. Everything else — acai bowls, fertility superfoods, pineapple core — has no meaningful evidence.
The Mediterranean Diet: Strongest Evidence
A 2018 study in Human Reproduction found that women who adhered closely to a Mediterranean diet before IVF had significantly higher clinical pregnancy rates (50% vs 29%) and live birth rates compared to those who did not. The diet emphasises:
- Vegetables, fruits, legumes, and whole grains as the foundation
- Olive oil as the primary fat source
- Fish and seafood 2–3 times per week
- Moderate dairy (yoghurt, cheese)
- Limited red meat (1–2 times per week maximum)
- Nuts and seeds daily
- Minimal processed food, sugar, and refined carbohydrates
Colombia, incidentally, makes this easy. Fresh fruits, vegetables, fish, and lean proteins are abundant, affordable, and delicious in Medellín and Bogotá.
Supplements with Evidence
| Supplement | Evidence Level | Recommended Dose | Who Benefits |
|---|---|---|---|
| Folate/folic acid | Strong | 800mcg–1mg daily | All IVF patients (start 3 months before) |
| Vitamin D | Moderate-strong | 1,000–4,000 IU daily | Patients with levels below 30 ng/mL |
| CoQ10 (ubiquinol) | Moderate | 400–600mg daily | Women over 35, poor responders |
| DHEA | Moderate | 75mg daily (25mg x3) | Poor ovarian responders (low AMH) — prescriber supervised |
| Omega-3 (fish oil) | Moderate | 1–2g daily | General egg quality support |
| Myo-inositol | Moderate | 4g daily | PCOS patients specifically |
| Vitamin E | Weak-moderate | 400 IU daily | May support endometrial thickness |
| Melatonin | Emerging | 3mg at bedtime | May improve egg quality (start 6 weeks before) |
Egg development takes approximately 90 days from dormant follicle to mature oocyte. This means supplements and dietary changes need to begin 3 months before your IVF cycle to meaningfully affect egg quality. Starting supplements the week before stimulation is too late to matter.
What to Avoid
- Alcohol: Eliminate completely during stimulation and after transfer. Even moderate alcohol consumption is associated with reduced IVF success
- Caffeine: Limit to 200mg/day (roughly one 12oz coffee). Higher intake is associated with slightly lower pregnancy rates
- Smoking: Reduces egg quality, ovarian reserve, and IVF success rates by 30–40%. Stop at least 3 months before treatment
- Extreme exercise: High-intensity training (CrossFit, marathon training) during stimulation can cause ovarian torsion and may redirect blood flow away from the reproductive organs. Switch to walking, yoga, and light swimming
- BPA and endocrine disruptors: Avoid plastic food containers (use glass), reduce canned food consumption, and choose BPA-free water bottles
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