IVF Nutrition Has Moved Beyond ‘Just Take Folate’

About the Author: Freya Lawler is a naturopath, nutritionist, and fertility educator who specialises in endometriosis, complex reproductive conditions, and IVF optimisation. She supports individuals and couples with evidence-based preconception care, focusing on egg and sperm quality, hormonal balance, gut health, and inflammation.

For years, nutrition during IVF was often reduced to a relatively short list of recommendations: Take folate. Limit alcohol. Eat reasonably well. Exercise.

But modern fertility research is increasingly moving beyond this simplified approach. While IVF may assist fertilisation, achieving a healthy pregnancy and supporting the development of a healthy baby remain deeply interconnected with the body’s wider biological systems.

Egg maturation, sperm development, fertilisation, implantation, placental formation, and early embryonic growth are all highly energy-dependent processes influenced by inflammation, oxidative stress, nutrient availability, mitochondrial function, and overall metabolic health^{(1, 2)}.

Increasingly, fertility specialists and researchers are recognising that nutrition is not simply about preventing deficiencies. It also influences the internal environment in which reproduction occurs.

This shift in perspective has become increasingly important as fertility rates continue to decline globally and more couples than ever are turning to assisted reproductive technologies such as IVF. In Australia and New Zealand alone, over 112,000 ART cycles were performed in 2023, yet the live birth rate per initiated cycle remains relatively modest at approximately 23 to 24% ⁽³⁾. While IVF can assist fertilisation and embryo transfer, it cannot completely override the fundamental foundations required for successful implantation, placental development, immune tolerance, and healthy fetal growth.

As a result, reproductive health research is increasingly exploring the role of inflammation, oxidative stress, metabolic health, environmental toxins, and mitochondrial function in reproductive outcomes ⁽⁴⁾.

Mitochondria, often referred to as the “energy powerhouses” of our cells, play a particularly critical role in fertility. Egg cells contain the highest concentration of mitochondria in the human body because reproduction is an extraordinarily energy-demanding process. From chromosome division to embryo development and implantation, these processes rely heavily on adequate mitochondrial energy production ⁽⁵⁾.

Emerging research now suggests mitochondrial dysfunction may contribute to reduced egg quality, ovarian ageing, impaired embryo development, and lower reproductive potential^{(5, 6)}. Oxidative stress, which may be increased by factors such as chronic inflammation, smoking, poor sleep, insulin resistance, environmental toxin exposure, and repeated ovarian stimulation cycles, can damage both mitochondrial DNA and cellular function over time ^{(2, 6)}.

Key Nutrients Involved in Mitochondrial Function

Because mitochondria are responsible for generating the energy required for egg maturation, fertilisation, embryo development, and implantation, researchers are investigating the role specific nutrients may play in supporting mitochondrial health during IVF and the preconception window.

Some of the key nutrients involved in optimal mitochondrial function include:

• • • CoQ10 (Coenzyme Q10), involved in cellular energy production and antioxidant protection
    • Vitamin D, supports ovarian signalling, immune regulation, and mitochondrial function
    • Omega-3 fatty acids, help regulate inflammation and protect mitochondrial membranes
    • Magnesium, essential for ATP (energy) production
    • B vitamins (particularly B2, B3, B6, folate and B12), required for energy metabolism and DNA synthesis
    • N-acetylcysteine (NAC), supports glutathione production and antioxidant defence
    • Alpha-lipoic acid, helps reduce oxidative stress and regenerate antioxidants
    • L-carnitine, assists the transport of fatty acids into mitochondria for energy production
    • Zinc, involved in DNA repair, hormone signalling, and oocyte maturation
    • Selenium, supports antioxidant enzymes and thyroid function
    • Melatonin, emerging research suggests it may help protect eggs from oxidative stress

While research in this area is still evolving, many of these nutrients are now being investigated for their potential roles in supporting egg quality, embryo development, sperm health, and reproductive outcomes during IVF.

In recent years, Vitamin D has emerged as an increasingly important nutrient in reproductive medicine. Beyond its traditional role in bone health, vitamin D appears to influence ovarian follicle development, hormone signalling, endometrial receptivity, immune regulation, and egg quality ⁽⁷⁾. Low vitamin D levels have been associated in several studies with poorer IVF outcomes, reduced pregnancy rates, and impaired embryo development, although research is still evolving ^{(7, 8)}.

Despite this, vitamin D deficiency remains incredibly common, and vitamin D status is not always routinely assessed during preconception care unless patients specifically request testing or present with recognised risk factors. Deficiency is particularly common in populations with limited sun exposure, indoor lifestyles, darker skin tones, autoimmune conditions, higher BMI, and in geographical regions or states with lower sunlight exposure during winter months. Given the widespread prevalence of deficiency, assessing and optimising vitamin D status before IVF represents an important and often overlooked aspect of reproductive care.

This is one reason why IVF nutrition has moved beyond “just take folate.”

Folate remains incredibly important, particularly for neural tube development and methylation pathways, but modern preconception nutrition is now increasingly focused on supporting mitochondrial function, antioxidant capacity, metabolic health, inflammation regulation, and overall cellular function.

Rather than simply preventing deficiency, achieving optimal nutrient status may help create a more supportive environment for fertilisation, implantation, and pregnancy to occur.

Importantly, none of this is about striving for perfection or placing additional pressure on individuals already navigating the emotional and physical demands of IVF. Fertility can be so complex, and many factors remain outside of our control. However, research does suggest that supporting the body’s nutritional status, metabolic health, and mitochondrial function may help create a more supportive environment for reproduction to occur.

This is why advocating for yourself throughout the IVF process really matters. Asking your GP or fertility pecialist for more comprehensive preconception blood testing, including nutrients such as vitamin D, iron studies, B12, folate, zinc, selenium, thyroid markers, and metabolic screening such as fasting insulin and glucose testing, may help identify factors that are not always routinely investigated. Focusing on nutrient-dense whole foods, reducing ultra-processed foods where possible, supporting sleep and stress regulation, and using a high-quality prenatal or multivitamin (based on the latest evidence) may all help support reproductive health and reduce the risk of nutrient deficiencies before and during treatment. While nutrition alone cannot guarantee IVF success, these foundational strategies may help give your body, your future pregnancy, and your baby the strongest possible start.