What to Eat for IVF

I'm a reproductive endocrinologist who has been helping people build their families for over 15 years. Most individuals who plan to conceive, have trouble conceiving, or undergo IVF want to know how to improve their overall fertility, and nutrition can often play a critical role.

Before we begin…

Before I get into the details, I want to state that I recognize how diet can be a sensitive topic. I’m always mindful about how I talk about food because it can be triggering. When you’re trying to build a family, there’s a tendency to seek control, which can become punitive. People can associate eating nutritiously with being “good” and eating less nutritiously as being “bad.” This mindset can spiral into disordered eating, where the internal narrative is, “I didn’t get pregnant again this month. I guess I didn’t follow the diet close enough. This is my fault. I’m going to be even more strict in my next cycle.” 

So, if you have a history of disordered eating and are feeling triggers in your fertility journey, please seek help. Find the support that you need. 

Moderation is key

My nutrition recommendations when undergoing IVF are based on evidence. This might be a spoiler, but the main takeaway is to eat everything in moderation. For the most part, eat well. Enjoy more fruits and vegetables. Avoid highly processed food. But, show yourself grace when you enjoy something less nutritious once in a while. 

For reference, when I discuss a typical Western diet, here’s what I mean: 

• Meat heavy, particularly red meat 

• Heavy in processed foods 

• Refined grains, such as white rice and white bread

• Refined sugars, which include soda 

You’ve likely heard of the ketogenic diet, or Atkins, which was popular about a decade ago. It restricts carbohydrates in favor of fats and animal proteins. While there are many variations of these low-carb diets, the general approach is consuming as few carbs as possible while loading up on eggs, bacon, and other types of meat. 

Another diet you hear a lot about is the paleo diet, which tries to mimic the foods humans consumed in the Paleolithic era. Essentially, it favors whole foods, meat, and limited dairy and processed foods. 

Other diets include a vegetarian diet (no meat or animal products, but sometimes dairy) and a vegan diet (no animal products or byproducts). 

Now, let’s see what the data says.

The Mediterranean diet for fertility

When I mention a Mediterranean diet, I mean: 

• Fruit and vegetable-heavy 

• Lean meats, such as fish 

• Poultry, like chicken

• Less processed foods

• Lots of olive oil 

The Mediterranean diet has been shown time and time again to be one of the best diets for fertility: 

• One 2011 study out of Spain compared the diets of women struggling with infertility to women who have not had infertility. The people without a history of infertility had strong tendencies towards a Mediterranean-like diet: high in fruits and vegetables, some lean meats for protein, and limited processed foods.

• An interesting 2010 study out of the Netherlands showed that women had a 40% higher chance of success with their IVF cycle if they were more adherent to a Mediterranean diet beforehand. 

• Another study out of the Netherlands observed a lower miscarriage rate in pregnant individuals who followed a Mediterranean diet. 

• Multiple studies indicate that a Mediterranean-like diet is helpful for sperm parameters and improves sperm parameters over time. 

Long-story-short: The Mediterranean diet is associated with a positive impact on fertility in whatever aspect you look: time to get pregnant, success with IVF, lower miscarriage rate, and male factor fertility. 

The fertility diet for fertility

Interestingly, there’s a diet that’s called the fertility diet. This diet was labeled after researchers observed a large group of people (17k+) going through their fertility journeys for years. Multiple aspects of health were observed, including: 

• Types of food eaten

• The food’s association with regular menstrual cycles and ovulation

• Time to conceive 

• Overall fertility 

The results showed that women conceived faster when consuming: 

• More protein from vegetable sources than meat 

• Carbohydrates with a low glycemic index 

• Whole-fat dairy products

• Multivitamins with folic acid

• Iron from plants and supplements 

The pro-fertility diet for fertility

Another diet called the pro-fertility diet has been studied closely in our fertility community. A group of physicians and nutritionists designed this diet as part of their overall Environment and Reproductive Health (EARTH) study. 

As part of their conclusions, researchers observed women’s ovulation cycles, menstrual cycles, and overall fertility over some time and then worked backward to see what different people were eating. 

The pro-fertility diet includes: 

• Low-pesticide exposure in fruits and vegetables

• Consumption of whole grains, seafood, dairy, and soy products

• Vitamin B and D supplements, along with folic acid

In 2019, a study observing 300+ patients undergoing IVF showed higher success rates when following the pro-fertility diet compared to the typical Mediterranean diet.

Paleo, keto, or Atkins diets for fertility

I could not find specific studies that compared paleo, Atkins, or keto diets for fertility. 

However, as far as fertility is concerned, I advocate for balance over extremes. 

Vegan or vegetarian diets for fertility

There aren't great studies that compare vegan or vegetarian diets as far as fertility is concerned. However, specific studies associate high animal protein consumption with lower fertility rates for couples, difficulty with ovulation, and poor sperm parameters. 

On the flip side, I think anyone following vegetarian or vegan diets must be careful. There’s a conception that plant-based is healthier, but in reality, we have to consciously find protein resources. 

(For example, an Oreo cookie is technically vegan, but a diet full of Oreo cookies isn’t going to be very healthy.) 

If you’re following a vegan or vegetarian diet, please work with a nutritionist or a dietitian to ensure you get adequate protein and a well-balanced diet. 

Let’s recap

• Nutrition is essential for your fertility. 

• A nutritious diet can lead to lower miscarriage rates and IVF success rates. 

• The most well-studied diet associated with the highest fertility rates is a Mediterranean diet, which is heavy in fruits and vegetables with fish and chicken as animal protein.

• Other diets remind us that vitamin D, folic acid, and iron are important. 

• Whole-fat dairy products are associated with higher fertility. 

Studies aside, I believe in balance. One of my favorite Chinese proverbs is “perfection is 80%.” You are doing great if you’re eating leaner meats, fruits, and vegetables 80% of the time. Try to find balance in your approach to nutrition. For questions or comments, please visit my YouTube video.