Although IVF outcomes can’t be guaranteed, you can do a lot to improve your chances. This guide will walk you through the main factors that can impact IVF success, explain what tests need to be done before IVF, and show you how to make IVF successful the first time as much as possible with actionable tips for every stage of the treatment.
3 main factors that can impact IVF success
No two IVF journeys are the same, but some factors play an important role in determining the outcome. The main aspects to consider are:
Age of the mother (or egg donor)
Age of the father (or sperm donor)
Type of fertility issues and reproductive history
Source: Nataliya Vaitkevich
1. Age of the mother (or egg donor)
The age of the woman providing the egg is among the most significant predictors of IVF success because egg quality and quantity decline steadily over time, particularly after the age of 35.
See IVF success rates by maternal age in the table below:
Maternal age | Success rates |
|---|---|
Under 35 | 41.6% |
35–37 | 29.6% |
38–40 | 18.7% |
41–42 | 9.2% |
Over 42 | 2.8% |
If you’re not ready to start a family yet, freezing your eggs can give you more options later. For couples ready to plan ahead, freezing the embryos is even better because the chances of survival are higher.
You can also consider using donor eggs if you’re over 38, and especially over 40. Although age plays a huge role, success is possible, even later in life.
2. Age of the father (or sperm donor)
Sperm quality also decreases as you get older, especially after age 45.
Older paternal age increases the risk of spontaneous genetic mutations in children, not present in either parent, and a higher risk of developmental and neuropsychiatric conditions, such as autism and schizophrenia.
Older paternal age has also been linked to DNA fragmentation in sperm (the presence of damaged DNA), which is associated with reduced male fertility and other adverse outcomes.
If you’re not ready to start a family yet, consider freezing your sperm at a younger age. Alternatively, you can use donor sperm since it typically comes from younger, carefully screened individuals, often below the age of 38.
3. Types of fertility issues and reproductive history
The underlying cause of infertility (whether male or female) can influence which IVF protocol will work best. For example:
Endometriosis can affect egg quality and embryo implantation, so surgical approaches may be necessary.
PCOS may require careful hormone dosing.
Low sperm count or motility may require intracytoplasmic sperm injection (fertilization by inserting a single sperm into an egg).
A history of pregnancy loss or failed IVF cycles may signal genetic or uterine issues that need addressing.
What tests need to be done before IVF to make it successful?
Before you start your first IVF cycle, you and your partner (or donor) will typically undergo a series of medical evaluations so your fertility team can understand your reproductive health, identify potential risks, and tailor a treatment with the highest chance of success.
The testing process usually involves:
Bloodwork
Ovarian reserve testing
Uterine lining and pelvic ultrasound
Semen analysis
Mock embryo transfer
Genetic screening
1. What blood tests are done before IVF?
Blood tests reveal hormonal imbalances, infections, or underlying health conditions that can affect your IVF outcomes or the success of your future pregnancy.
The table below shows what tests are done before IVF (though not all are required in every case):
Hormonal blood tests | Infectious disease screening | General health tests |
|---|---|---|
|
|
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2. What is ovarian reserve testing?
Ovarian reserve testing helps determine how many eggs you’re likely to produce during an IVF cycle and how well your ovaries may respond to fertility medicine.
This set of tests normally includes:
Anti-Müllerian hormone (AMH): A blood test that estimates your remaining egg supply.
FSH and estradiol: Hormone levels are checked on days 2–3 of your menstrual cycle to assess ovarian function.
Antral follicle count (AFC): A transvaginal ultrasound that counts small follicles in both ovaries and helps predict egg yield.
Source: Maksim Goncharenok
3. What does a uterine lining and pelvic ultrasound involve?
A healthy uterus is essential for successful implantation and pregnancy. Before starting IVF, your doctor will examine the uterus to rule out abnormalities that could interfere with treatment. Common tests include:
Pelvic ultrasound: A transvaginal ultrasound to assess the uterus and ovaries. Detects fibroids, cysts, polyps, and thickness of the endometrium (uterine lining) that may affect implantation.
Sonohysterography (saline ultrasound): Uses sterile fluid for clearer ultrasound images. Can reveal subtle abnormalities in the uterine cavity.
Hysteroscopy: A minimally invasive camera procedure to visualize the uterine cavity. Recommended after abnormal imaging or failed IVF cycles
4. What does semen analysis include
Semen analysis is a standard part of the IVF workup, which examines:
Semen volume: How much fluid is produced in a single ejaculate
Sperm concentration (or sperm count): The number of sperm per milliliter of semen
Sperm motility: The percentage of sperm that are moving and how well they swim
Sperm morphology: The size and shape of the sperm, which can impact their ability to fertilize an egg
Vitality: The percentage of live sperm in the sample
pH level: The acidity or alkalinity of the semen, which can affect sperm health
Time to liquefaction: How long it takes for semen to change from thick to a more liquid form (a process that helps sperm move more quickly)
White blood cells are also examined because a high count may signal infection or inflammation that could impair fertility.
If any abnormalities are found, your doctor may recommend additional testing, such as the Sperm Chromatin Structure Assay (SCSA), which evaluates the integrity of sperm DNA.
5. How does mock embryo transfer work?
A practice or mock embryo transfer is a simple, non-invasive procedure that some clinics recommend before the actual transfer. It doesn’t involve a real embryo, but it helps your care team stimulate a smooth transfer. Your doctor will insert a thin, flexible tube with sterile fluid through the cervix and into the uterus.
The entire process takes a few minutes and requires no sedation. Most patients describe it as similar to a Pap smear.
The mock transfer allows your doctor to:
Measure the exact depth and angle of your uterus
Identify any obstacles, such as tightness in the cervix or unusual curvature
Choose the best catheter and insertion technique
6. Why is genetic carrier screening necessary?
Even if you and your partner are perfectly healthy, you may unknowingly carry inherited genetic conditions that could affect your child.
Carrier screening detects these risks before IVF begins. It is especially beneficial if you have a family history of inherited conditions or you’ve experienced miscarriages with unknown causes.
Standard panels screen for common conditions, such as cystic fibrosis, Tay-Sachs disease, sickle cell disease, and thalassemia. These are important, but they represent only a fraction of the unknown inherited conditions. More advanced options, such as whole-genome carrier screening, can screen for hundreds of conditions that typical panels miss.
How to prepare for an IVF cycle
Preparation for your first IVF cycle is essential. Maintaining a healthy weight, managing stress, and choosing the right clinic and doctors can all influence your success.
These factors are within your control, so here are two key areas to focus on before your cycle begins:
Making targeted lifestyle changes
How to boost IVF success with targeted lifestyle changes
Some lifestyle changes can make a real difference and give your body the best chance to respond well to fertility treatment.
Here’s what to do:
Follow a fertility-friendly diet: Opt for a Mediterranean diet with plenty of fresh fruit and vegetables, whole grains, legumes, lean protein (such as fish and poultry), and healthy fats (like avocados, nuts, seeds, and olive oil). Avoid red meat, sugar, alcohol, caffeine, and processed food.
Take supplements: Talk to your doctor about prenatal vitamins with folic acid and vitamin D. CoQ10 may contribute to egg quality and quantity, and fish oil can support embryonic development.
Exercise gently: Avoid high-impact activities like long-distance running. Walking, yoga, light cardio, and strength training are excellent options.
Sleep well: Aim for seven to eight hours a night and try to fall asleep between 10 and 11 p.m., when melatonin peaks. This hormone supports sleep and reproductive health.
Reduce stress: Try meditation, journaling, acupuncture, and spend quality time with family and friends. Breathing exercises can also help.
Time sex carefully: Intimacy is fine, but men should avoid ejaculating three to four days before sperm retrieval. Deep penetration should also be avoided because it can irritate the cervix.
Avoid harmful chemicals: Switch to non-toxic personal care and cleaning products, without formaldehyde, parabens, flame retardants, and phthalates.
Flag medications that could interfere: Tell your doctor about any prescription drugs, over-the-counter medications, or supplements. For example, antidepressants or steroids may need dosage adjustment before the cycle.
Stop smoking and vaping: These activities directly reduce sperm and egg quality.
The father (sperm donor) should also take additional steps to support sperm health, such as avoiding hot tubs, car seat heaters, or unnecessary exposure to heat.
Source: Nathan Cowley
How to increase IVF success with the right fertility clinic
IVF success rates vary across clinics, so you should take the time to find a clinic that matches your goals, values, and medical needs.
Here’s what to look for:
Live birth rate per egg retrieval, rather than only pregnancy rate: Focus on cumulative live birth rates using patients’ own eggs because that reflects your real odds of having a baby.
Experience with your specific case: Ask about the experience treating people of your age, diagnosis, and medical history.
Personalized care: Choose a clinic that offers tailored treatment and is transparent about protocol adjustments, pricing, and success expectations.
Data transparency: Reputable clinics will share their data, ideally broken down by age, diagnosis, and cycle type.
Use of modern techniques and labs: Your clinic should work with a high-quality embryology lab, provide preimplantation genetic testing, and offer advanced sperm or egg retrieval options, such as extracting sperm directly from the testicle if necessary, as well as different ultrasound options to guide the needle to the ovaries.
Proximity: IVF requires multiple visits, so you should be able to travel to your clinic easily.
What are the requirements for IVF during treatment?
Once your IVF begins, success can depend on adhering to your treatment plan, including:
Following your medication schedule exactly, as gonadotropins, antagonists, and progesterone need to be taken at specific times
Attending all monitoring appointments and doing the necessary ultrasounds and blood tests during the IVF cycle to track how your body is responding and make adjustments if needed
Maintaining open communication with your fertility team so you can ask questions if any step is unclear, and report any side effects quickly
During the IVF treatment, you may also be offered preimplantation genetic testing (PGT) to screen embryos for chromosomal abnormalities before transfer. It’s not always necessary, but it can improve the chances of selecting the strongest embryo.
Here are the IVF genetic testing options:
PGT-A: Screens embryos for an abnormal number of chromosomes
PGT-M: Tests for specific single-gene disorders, such as cystic fibrosis, muscular dystrophy, hemophilia, or Tay-Sachs, when one or both parents are known carriers
PGT-SR: Detects unbalanced chromosome rearrangements, which can lead to miscarriage or genetic conditions
PGT-P: Assesses embryos for complex conditions influenced by many genes, such as heart disease or diabetes
PGT can also reveal the sex of an embryo with an accuracy of over 98%.
Bonus read: Learn more about preimplantation genetic testing in these guides:
What to do to make IVF successful after treatment
The period after embryo transfer is as crucial as the treatment itself. Your doctor will provide detailed instructions, but here is what you can typically do to improve the chances of success:
Avoid strenuous exercise and heavy lifting.
Continue with all prescribed medications.
Never self-medicate.
Focus on a nutrient-rich diet with folic acid, omega-3s, and iron.
Get enough quality sleep (seven to nine hours).
Don't skip scans and blood tests to track embryo progress and catch issues early.
Once you get a positive test result, try to control your excitement. It’s natural to feel ecstatic, but try to avoid overwhelming emotions and focus on the next steps.
Even if the test is negative the first time, remember that IVF can be unpredictable, and it may require multiple attempts. Fertility treatment can have ups and downs, so perceive every setback as a chance to learn and explore what might have contributed to such an outcome.
Why choosing the right embryo matters
Not all embryos have the same chance of resulting in a healthy pregnancy. Even among those labeled “normal” after basic screening, differences can exist in genetic potential, developmental quality, or long-term health outcomes.
Choosing the right embryo increases the odds of implantation and reduces the risk of miscarriage, but it can also help you lay the strongest foundation for your child’s future.
Advanced testing and transparent care can provide additional information about your embryos’ health and well-being potential, allowing you to make a more informed choice based on data.
This is where Nucleus IVF+ can help. It’s the first IVF option built for genetic optimization, helping parents maximize their chances of success from the very first cycle.
With Nucleus IVF+, you’re supported at every stage, from choosing the right clinic and donor, if necessary, to selecting the most comprehensive genetic tests, and ultimately, identifying the embryo with the best chance of leading to a healthy pregnancy and baby.
Nucleus combines advanced science with personalized care, helping you turn one of the most uncertain journeys into a more confident and hopeful path to parenthood.
Nucleus IVF+: Science on your side
Nucleus IVF+ is a comprehensive IVF solution that supports future parents at every step, from the first appointment to embryo selection and personalized care throughout the process.
Parents ready to start IVF can schedule a consultation with Nucleus. The team will connect you with a vetted partner clinic and guide you through the entire process, ensuring access to best-in-class support, treatments, genetic testing, and care.
Nucleus IVF+ includes:
Initial consultation, onboarding, and personalized guidance throughout your IVF cycle
24/7 concierge support and expert assistance from genetic counselors
Two whole-genome carrier screening tests and reports on 2,000+ conditions (the Nucleus Family kit)
PGT testing and Nucleus Embryo software to compare up to 20 embryos across health and well-being traits
Insights for 30+ complex conditions and traits for each embryo
All-inclusive IVF cycles, encompassing medications, ICSI, AMH, and STD tests
Ongoing genetic insights to understand your own health
Nucleus is HIPAA compliant and also offers independent packages for DNA testing and embryo screening. Fill out this form to tell us what you need.
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Featured image source: Nataliya Vaitkevich
