Before You Start IVF: What Men Can Fix in 90 Days

Reviewed by Dr. Dimberg, reproductive endocrinologist.

She's had the bloods, the scans, the dye tests, maybe the laparoscopy. Her cycle has been tracked to the day for two years. You did one semen analysis, someone said "a bit low, keep them cool", and the next thing on the table was IVF.

If that sounds familiar, you're not alone. Male factor is involved in around half of couples who struggle to conceive, yet the male side is often assessed in one test and a short conversation. Private IVF in the UK costs £5,000+ per cycle, and the male half of the embryo comes from sperm made in the three months before egg collection.

This guide is for couples who haven't started IVF yet. It's about the 90 days before you do: what to check, what to ask, and what you can actually change.

Why the 90 days before IVF matter

Sperm take roughly 74 days to make, plus about 2 weeks to mature. That means:

• The sperm used on the day of egg collection are being made right now.
• A semen analysis from months ago describes a batch that's already gone.
• What you do in the next 90 days decides the quality of the sperm your clinic will actually work with.

Better semen numbers can also change which treatment is recommended. Many clinics look at your total motile sperm count (TMSC). Above roughly 5 to 10 million, IUI or trying naturally may still be an option. Below that, IVF or ICSI is usually advised. Moving your TMSC before your consultation can change that conversation.

Step 1: Get properly checked (not just one test)

One semen analysis isn't a full male assessment. Before you start IVF, ask for:

• A repeat semen analysis. Results vary a lot from sample to sample. NICE suggests repeating an abnormal result about 3 months later.
• An examination by a urologist or andrologist, not just a lab result. Varicocele (enlarged veins in the scrotum) is one of the most common treatable causes of poor sperm quality, and it's found by examination.
• Hormone bloods if your count is low: testosterone, FSH and LH.
• A conversation about sperm DNA fragmentation testing if you've had unexplained results or previous failed cycles. It isn't routine, and evidence on when it helps is still developing, so ask your clinic whether it's useful for you.

What every number on your semen analysis means.

Step 2: Questions to ask your clinic

Bring these to your next appointment:

1. "What's my TMSC, and what number would change your recommendation?"
2. "Has a specialist examined me, or only looked at my semen analysis?"
3. "Should I retest after 90 days of changes before we decide on treatment?"
4. "Is there anything in my bloods or history (past testosterone, steroids, finasteride, a high fever) that explains my result?"
5. "If we go ahead with IVF, would ICSI be recommended based on my numbers?"

Step 3: Stop the damage for 90 days

• Smoking and vaping: stop completely.
• Alcohol: cut it right down.
• Heat: no hot tubs, saunas or long hot baths. Keep the laptop off your lap.
• Sleep: 7 to 8 hours.
• Weight: even a modest loss helps hormones.
• Testosterone, TRT, steroids or hormone "T boosters": don't start them. External testosterone can switch sperm production off. If you already take them, speak to your doctor before changing anything.

Step 4: Supply what sperm production uses

Sperm production depends on specific nutrients, and these are the ones the research measured:

The honest picture: studies show these nutrients improving individual semen numbers, mostly in small trials. Antioxidants like vitamins C and E have been linked to lower sperm DNA damage in some studies. No supplement has been proven to raise live birth rates on its own (Cochrane 2022; MOXI trial 2020). But you have 90 days before treatment either way, and these are the inputs the research tested.

Check the doses. Most men's fertility tablets carry a fraction of these amounts. Wellman Conception, the UK's best-known one, has 2mg of CoQ10 against trial doses of 200mg. See 7 supplements compared by dose.

Step 5: Retest before you commit

Book a repeat semen analysis about 90 days after you start. Keep the abstinence gap the same as your first test, and compare count, progressive motility, morphology and TMSC line by line. Walk into your treatment consultation with the best numbers you can build, and with a result that reflects the man you are today, not the one from three months ago.

For her: how to raise it

If you're the partner reading this: you've likely carried most of the tests so far. It's completely reasonable to ask the clinic for a fuller male assessment before you start, and to suggest a 90-day reset you can do together. Framing it as "making sure we've given ourselves the best possible start" usually lands better than "your result was low".

Where SPERMFUEL+ fits

We built SPERMFUEL+ for the 90-day window before the next test or treatment decision: 14 fertility nutrients in 2 capsules a day, with every dose printed.

• Speed: CoQ10 200mg, acetyl-L-carnitine 440mg
• Count: zinc 30mg, vitamin D3 4,000 IU, boron 10mg
• Shape: selenium 200mcg, methylfolate 800mcg, methyl-B12 48mcg, B6 (P5P) 8.5mg, vitamins C and E

It comes with a 120-day money-back guarantee, long enough to cover a full sperm cycle and your retest. If you're already part-way through treatment, speak to your clinic before starting any supplement. See the full label.

FAQ

Should men take supplements before IVF? Many clinics suggest a healthy routine and antioxidant support for men in the months before treatment. Studies show individual semen numbers improving with nutrients like CoQ10, carnitine and selenium. Ask your clinic, and start at least 90 days before.

How long before IVF should a man start improving his sperm? At least 90 days, because sperm take about 74 days to develop plus around 2 weeks to mature.

Can better sperm numbers avoid IVF? Sometimes. Clinics often use total motile sperm count (TMSC) to decide between trying naturally, IUI and IVF or ICSI. Improving your numbers can change the recommendation, so retest before you decide.

Does sperm quality affect IVF success? Sperm quality affects fertilisation and embryo development, which is why ICSI is used when numbers are very low. Ask your clinic how your results affect your treatment plan.

What should men avoid before IVF? Smoking, heavy drinking, heat (hot tubs, saunas), and starting testosterone or steroids, which can switch off sperm production.

References

1. NICE. Fertility problems: assessment and treatment (CG156). National Institute for Health and Care Excellence. Source
2. World Health Organization. WHO laboratory manual for the examination and processing of human semen, 6th edition. 2021. Source
3. Greco E et al. Reduction of the incidence of sperm DNA fragmentation by oral antioxidant treatment. J Androl, 2005. PubMed
4. Bakri S et al. Efficacy and Safety of Coenzyme Q10 in Idiopathic Male Infertility: A Systematic Review and Meta-Analysis of Randomized Trials. World J Mens Health, 2026. PubMed
5. Lenzi A et al. A placebo-controlled double-blind randomized trial of the use of combined l-carnitine and l-acetyl-carnitine treatment in men with asthenozoospermia. Fertil Steril, 2004. PubMed
6. Scott R et al. The effect of oral selenium supplementation on human sperm motility. Br J Urol, 1998. PubMed
7. de Ligny W et al. Antioxidants for male subfertility. Cochrane Database Syst Rev, 2022. PubMed
8. Steiner AZ et al. The effect of antioxidants on male factor infertility: the Males, Antioxidants, and Infertility (MOXI) randomized clinical trial. Fertil Steril, 2020. PubMed
9. Michaelsen MP et al. The Effect of Dietary Supplements on Male Infertility in Terms of Pregnancy, Live Birth, and Sperm Parameters: A Systematic Review and Meta-Analysis. Nutrients, 2025. PubMed