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Targeted Assessment · Fertility · IVF · Pre-Conception

Invest in the Biology
Before the IVF Cycle

A single IVF cycle costs upward of £5,000. Egg quality, uterine receptivity, and implantation success are all substantially influenced by nutritional status nobody at the fertility clinic is assessing. CoQ10, methylfolate, vitamin D, zinc, selenium, inositol — specific, measurable, correctable.

90-day windowFollicular development cycle — start 3 months before
Both partnersMale fertility nutrients assessed alongside female
MTHFR testingCritical for folate pathway and antidepressant response
£395Full pre-conception assessment
Who this is for

Planning IVF, IUI, or natural conception — especially after previous cycle failure or recurrent miscarriage

Egg quality is the single most important factor in IVF success — and it is nutritionally dependent. The oocyte has more mitochondria than any other cell. Mitochondrial energy production requires CoQ10. Eggs need a lot of energy, and CoQ10 is part of how cells make it (mechanistic). This is correctable. Nobody at the fertility clinic is checking it. Doses are set individually after testing, with your other medicines checked.

What we assess

The markers that aren't being checked

CoQ10 / Mitochondrial status
Rate-limiting for egg quality. Declines with age. A meta-analysis of 5 small trials (449 women) found more clinical pregnancies (28.8% vs 14.1%) but no difference in live birth (Florou 2020).
Not measured at fertility clinics. Correction takes 90 days — the exact length of follicular development.
Methylfolate / MTHFR status
Folic acid requires MTHFR to convert to active methylfolate. 40% of population have variants reducing conversion by 35–70%. These individuals need 5-MTHF directly. MTHFR variants are associated with higher miscarriage rates and implantation failure.
Most fertility clinics still recommend folic acid — wrong for 40% of patients.
Vitamin D
Meta-analysis: vitamin D-sufficient women have 34% higher clinical pregnancy rates per IVF cycle. Uterine receptivity and immune tolerance of implantation are both vitamin D-dependent. My working range: 75–125 nmol/L (30–50 ng/mL), a clinical target, not official guidance.
No guideline sets a fertility target. The Endocrine Society suggests vitamin D in pregnancy without testing first (Demay 2024).
Selenium
Essential for glutathione peroxidase in follicular fluid — protects the developing oocyte from oxidative damage. UK soils severely selenium-depleted. Lower follicular fluid selenium associated with poorer fertilisation rates.
UK dietary selenium is among the lowest in Europe.
Zinc
Essential for oocyte maturation, fertilisation (the zinc spark), and early embryo development. Critical for sperm production, motility, and DNA integrity in male partners.
Homocysteine / Methylation
Elevated homocysteine is associated with increased miscarriage risk and implantation failure. Measurable, modifiable with methylfolate, B12, B6. Not routinely checked in fertility workups.
Directly measurable from blood draw. Should be standard — it isn't.
Targeted Assessment Service
DH Pre-Conception Nutritional Assessment
Complete nutritional investigation for both partners · MTHFR testing · Hormone context · Written protocol for the 90-day pre-conception window
What's included
Blood chemistry — vitamin D, zinc, selenium, folate, B12, homocysteine, CRP, fasting insulin, full thyroid including TPO/TgAb antibodies
MTHFR status — C677T and A1298C variants to determine folate form requirement
Functional CoQ10 assessment where available; ubiquinol protocol based on clinical picture
Male partner basic fertility nutrient panel — zinc, selenium, vitamin C, omega-3 index
Written interpretation report with specific supplement protocols and timing
90-day pre-cycle protocol with 6-week check-in
What you'll know
Whether you carry MTHFR variants requiring methylfolate rather than folic acid
Your vitamin D status against fertility-specific targets
Selenium, zinc, and antioxidant status protecting egg and sperm quality
Homocysteine and methylation status — independent miscarriage risk factor
Thyroid antibodies — Hashimoto's significantly increases miscarriage risk even with normal TSH
A specific, timed supplement protocol for both partners for the 90-day pre-conception window
Assessment fee
£395
Lab costs additional where applicable.
Book a free 20-minute call →
Further reading

The clinical evidence behind this service

Clinical Essay
What Your Fertility Clinic Isn't Telling You
Clinical Essay
The Thyroid Is the Last Thing They Test
The Gap Series
Normal Is Not the Same as Optimal
Test
Blood Chemistry — The Markers That Matter

Not sure where to start?

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Describe your situation — the concierge can help clarify what investigation makes most sense for your specific picture.

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