
Why Birth Control Pills Are Key to IVF Success
How does birth control work with IVF?
Birth control pills function by suppressing a woman’s hormones and preventing ovulation, thereby making pregnancy impossible or extremely unlikely.
Specifically, Dr. Doherty explained that birth control pills prevent the growth and development of a woman’s follicles (each of which contains an egg) and keep her endometrial lining thin.
Without the development of one primary or lead follicle, ovulation will not occur, and without an adequate uterine lining, the embryo will not successfully implant inside the woman’s endometrium.
This baseline state is optimal for the start of IVF fertility treatment, where the goal of IVF is to grow as many follicles as possible in one cycle. After stopping birth control pills, self-administered hormone injections are used to stimulate the growth of the ovarian follicles.
“This coordinated growth allows us to maximize the number of mature fertilizable eggs at the time of egg retrieval,” Dr. Doherty said. “By preventing a ‘front-runner’ or lead follicle from developing by using a birth control pill, the follicles that develop during ovarian stimulation tend to be more synchronized.”
When else could birth control be used in reproductive medicine?
This ‘baseline state’ is also helpful for other fertility procedures, including HSG (Hysterosalpingogram) and SIS (Saline Infusion Sonogram).
Other circumstances that could prompt putting a woman into this baseline state include waiting on embryo testing results, insurance authorization for a treatment cycle, or facilitating surgical scheduling.
Once these things are completed, the pill is stopped, the menstrual cycle becomes “un-paused,” and treatment can resume.
In addition, because birth control pills reduce your body’s production of estrogen and progesterone, they can be taken (and are often prescribed) to relieve symptoms of endometriosis in women not trying to conceive.
What birth control pills are used in IVF?
At RMA, Dr. Doherty said, doctors typically prescribe combined oral contraceptive pills (OCPs), which contain both estrogen and progesterone.
These are the same as the birth control pills women take every day to prevent pregnancy. These OCPs are monophasic, meaning they have a steady dose of estrogen and progesterone and are well tolerated by women.
For women who cannot take OCPs, RMA doctors prescribe progesterone-only pills, the most common of which is norethindrone.
Before treatment, I was on birth control for over ten years. Could this have caused my infertility?
This question has a simple answer, says Dr. Emily Osman. And that answer is no.
“Being on birth control long-term does not cause infertility,” she said. “There are no differences in pregnancy rates, fertility treatment success, or miscarriage rates between women on long-term birth control pills versus those that are not.”
Dr. Osman said that once a woman decides to get off the pills, normal hormone production will be restored in women who were having regular cycles before the use of birth control pills.
She added that it may take up to three months to start having regular menstrual cycles after stopping the pill, but if your cycles do not resume after that time, you may want to consider seeing a fertility doctor.
Is there any reason not to go on the pill for IVF or otherwise?
According to Dr. Osman, you may want to avoid birth control pills if you have a history of high blood pressure or blood clots or if you are a smoker.