Why Do Doctors Suggest Birth Control Pills Before IVF Treatment
The birth control pill (BCP) is a hormonal method of preventing pregnancy. While it may sound contradictory, a doctor may prescribe this oral contraceptive before starting in vitro fertilization (IVF) treatment. Using this pill before IVF can help improve the effectiveness of the procedure by helping medical professionals schedule the optimal timing for treatment.
BCPs are oral contraceptives that people can take for several reasons, including preventing pregnancy. They work by using hormones to prevent the body from producing an egg. A doctor may suggest using BCPs to help control a person’s menstrual cycle and ovulation period, making it easier to manage and schedule the timeline of IVF treatment.
IVF is one of the most common and effective forms of assisted reproductive technology. This procedure involves fertilizing an egg outside the body, in a laboratory dish, and then implanting it in a person’s uterus. In addition to BCPs, an individual may also take fertility drugs to help support the treatment and early pregnancy.
In this article, we will discuss why a doctor may suggest using birth control before attempting IVF.
With IVF, timing is essential. Starting IVF medications and procedures at the right time can improve the likelihood of successful treatment. This is why a reproductive endocrinologist may suggest using BCPs before IVF. These medications can help prevent potential pregnancy complications and allow doctors to control the timing of ovulation to schedule treatment.
How do birth control pills work?
There are two main types of BCPs: combination and minipills. The former contains synthetic versions of the naturally occurring hormones estrogen and progesterone. The minipill only contains the synthetic form of progesterone, known as progestin.
During a typical menstrual cycle, the ovary releases an egg, which sperm can fertilize. Medications containing estrogen and progestin can stop ovulation and breakthrough bleeding to prevent pregnancy. The minipill works in a similar way, but only contains progestin and may not reliably suppress ovulation.
How do birth control pills support IVF treatment?
Each ovary contains ovarian follicles, small sacs that comprise fluid and one immature egg. In a typical menstrual cycle, one follicle becomes mature and can release an egg. Taking BCPs prevents this follicle from reaching maturity.
After an individual stops taking BCPs, they will begin taking IVF medications that promote follicle growth. Evidence suggests that pretreatment with BCPs may help with the timing and egg yield during ovarian stimulation.
Although taking BCPs before IVF may seem counterintuitive, medical professionals have found this to be an effective method for maximizing the chance of a successful IVF experience. However, some evidence suggests that taking BCPs may not be a suitable pretreatment.
Most people who use BCPs as part of an IVF cycle take them before starting IVF medications and procedures. Taking a BCP can be especially helpful for acquiring optimal IVF timings. Using BCPs before IVF is a possible approach to assist with cycle scheduling.
The length of time an individual should take BCPs before starting IVF can vary, as there is no set period. Some evidence also recommends taking a short break between BCPs and IVF. With this in mind, an individual should consult with a fertility specialist before starting BCPs for IVF and follow their guidance.
For example, in a 2020 study, participants took BCPs for 12–30 days, then had a 5-day period with no BCP treatment, followed by the start of an IVF cycle. In another study, participants took BCPs for 10–14 days, then had 2–3 days of no BCP treatment before undergoing IVF.
However, while researchers used these timings, they may not reflect clinical practice. Anecdotally, these treatment programs may last around 21–42 days.
Doctors most often prescribe combination pills that contain both synthetic estrogen and progesterone. They may advise that people take their medication once per day at the same time. Some of the most common brand-name BCPs include:
Ideally, a person should take monophasic BCPs, the pill that contains equal amounts of estrogen and progestin for an entire monthly cycle. For those who cannot take estrogen, a doctor may suggest the progestin-only pill.
Individuals taking BCPs may experience negative side effects. These can range from mild effects, such as nausea or constipation, to serious effects that include fainting or fever. Anyone experiencing side effects of BCPs should speak with their doctor immediately. There are many different BCP options, so finding a suitable option may require some trial and error.
Birth control refers to medications, devices, or procedures that temporarily cause infertility to prevent conception or pregnancy. Currently, there is no evidence to suggest that taking BCPs will have a negative effect on fertility after an individual stops using them.
A 2018 study followed 14,884 women after they stopped taking BCPs. Evidence indicates that taking BCPs for any length of time did not make it harder to conceive after discontinuing birth control. The research also notes that taking BCPs did not delay the time it took to conceive after stopping BCP treatment.
Taking BCPs can help prevent pregnancy. However, an individual’s ability to conceive will return to expected levels when they stop taking their medication. It may take up to a week for hormones to leave the body and a few weeks before the ovulation cycle begins.
Although BCPs are harmless for many individuals, it may be advisable for certain people to avoid this medication, according to the advocacy group Planned Parenthood. For example, a doctor will advise against taking BCPs containing estrogen for individuals who are older than 35 years and who smoke.
Additionally, people should also avoid BCPs if they have a history of:
* breast cancer
* heart attack or stroke
* blood clots
* high blood pressure
* migraine with aura
Before beginning BCP treatment, a doctor can analyze any potential risk factors and prescribe a safe birth control option.
The IVF journey is highly individualized. Many factors influence what medications and procedures a doctor chooses for each person.
The goal of IVF is to stimulate the ovaries to maximize the number of viable eggs. Some hormones and medications a doctor may consider using include:
* gonadotropin-releasing hormone analogs
* gonadotropins such as follicle-stimulating hormone and luteinizing hormone
* human chorionic gonadotrophin
Doctors may also recommend medications to help maximize IVF success. For example, they might prescribe progesterone injections into the muscle, which may help improve implantation and fertility. Additionally, antibiotics may minimize the chance of infection following an IVF procedure.
To learn more about what IVF medications are available, a person can speak with a fertility specialist.
Doctors may recommend taking BCPs before other fertility treatments or tests to help evaluate fertility. These procedures are most effective during certain periods of the menstrual cycle. Regulating the cycle with BCPs can make it easier to achieve the right timing for successful tests and treatments.
For example, a hysterosalpingogram (HSG) test can help identify any blockages in the fallopian tubes that may be preventing pregnancy. This process involves an X-ray of the cervix and the uterus.
Another common fertility test is the saline infusion sonohysterogram (SIS). An SIS procedure uses ultrasounds of the cervix and uterus to identify any abnormalities that might be affecting conception.
A doctor must perform these tests during a certain period of the menstrual cycle. Taking BCPs before HSG and SIS can help manage the timing and maximize the success of these tests.
Doctors may recommend BCPs before beginning IVF treatment. Treatment with BCPs helps manage the timeline for menstruation and ovulation.
Taking BCPs may also increase the number of healthy eggs available for fertilization while also reducing the likelihood of potential complications. However, BCPs are not suitable for everyone. Anyone interested in them should consult a doctor to discuss their options.
Under proper medical guidance, BCPs can support the success of an IVF cycle and future pregnancy.