Most of the IVF programs tend to begin with birth control pills. Patients are often quite surprised and confused as their fertility journey is going to begin with something that is supposed to work against it. So, how do BCPs (birth control pills) support IVF? Are they used in all programs? When are the fresh cycles more reasonable?
Usually, IVF doctors will advice to take birth control pills 3 or 4 weeks prior to the program. Here is why :
- BCPs can help ovaries to respond better to the stimulation
With the birth control pills, ovaries will take a short break, after which, they are tend to respond better to the stimulation.
- BCPs give the opportunity to plan further steps so that they fit the desired schedule
Birth control pills give a very good control over the timing and coordination of the cycle. Their intake can be planned the way that following medical procedures do not interfere with vacations, national holidays, working schedule or any other important events.
- BCPs help to reduce and prevent the formation of cysts
- BCPs help to synchronize the maturation of follicles
Normally, when the follicles start to grow, one of them will outgrow the other ones. The largest follicle will become dominant while the rest of them will stop progressing. Remember, that during the regular cycle, woman produces only one mature egg. During the IVF, aim of the stimulation is to produce higher number of follicles and eggs accordingly. Therefore, the maturation and dominance of only one follicle will not do the job.
With the birth control pills before stimulation, development and growth of the follicles is temporarily halted. After the intake of stimulation medications, follicles tend to grow at the same rate with the higher number of eggs available for the retrieval.
Stimulation without birth control pills
Birth control pills are not always recommended. For example, if the previous IVF program was unsuccessful, the doctor may decide to use different ovarian stimulation protocol on a fresh cycle, without BCPs.
Birth control pills may also be avoided when a patient has a cyst of a certain size. In this case, doctor will not risk with increasing the size of the cyst and will rather start stimulation on the fresh cycle.
The last but not least, over dosage of birth control pills may affect patient’s ovarian reserve. Several studies suggest that the excess use of oral contraceptives can decrease the number of eggs for IVF.
Taking all of the factors into consideration, IVF doctor will carefully study patient’s case and after a diligent examination will decide whether it will be helpful and supportive to use birth control pills in the program.
The approach in this case is very individual. It can not be generally concluded whether birth control pills should be used before stimulation or not. While a number of IVF programs are successfully completed with their help, BCPs are not always the best choice in other situations.