It is a common question whether fertility medications can be taken while also using birth control. This medical inquiry involves understanding the distinct mechanisms of these medications and the potential consequences of their combined use. Medical guidance is always necessary when considering fertility treatment.
How Each Medication Works
Birth control pills primarily prevent pregnancy by altering a woman’s natural hormonal cycle. Combination pills, containing synthetic estrogen and progestin, work by suppressing the release of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) from the pituitary gland. This suppression prevents ovulation, stopping egg release from the ovary. Progestin-only pills also thicken cervical mucus, creating a barrier that makes it difficult for sperm to reach an egg, and can thin the uterine lining to prevent implantation if an egg were to be fertilized.
Conversely, fertility medications are designed to stimulate the reproductive system to promote conception. Medications like clomiphene citrate and letrozole work by encouraging the body to produce more FSH and LH, which are hormones that stimulate the growth and development of ovarian follicles and trigger ovulation. Injectable gonadotropins, which contain FSH and sometimes LH, directly stimulate the ovaries to produce multiple eggs, often used in more advanced fertility treatments like in vitro fertilization (IVF). These medications enhance processes birth control inhibits.
Why Combining Them Is Counterproductive
Combining fertility medications with birth control pills is counterproductive because their mechanisms of action are in direct opposition. Birth control pills prevent ovulation by suppressing the hormonal signals necessary for egg development and release. The hormones in birth control, particularly estrogen and progestin, override the body’s natural ovulatory cycle.
When fertility drugs are introduced, their purpose is to stimulate the ovaries and induce ovulation. However, the suppressive effects of birth control pills will negate these stimulatory signals. This means fertility medications will not work as intended, as birth control prevents the hormonal environment needed for ovulation. Taking both simultaneously can lead to a waste of medication and may disrupt the menstrual cycle without achieving the desired outcome of stimulating egg production.
Potential Risks of Concurrent Use
Combining fertility pills with birth control can pose several health risks. The opposing hormonal effects can create a hormonal imbalance within the body. This imbalance may lead to irregular menstrual cycles, making it difficult to track natural ovulation patterns or assess the effectiveness of either medication.
Using fertility drugs without appropriate medical supervision and monitoring, especially when the body’s natural cycle is suppressed by birth control, can lead to adverse effects. Although less common with oral fertility medications, there is a risk of Ovarian Hyperstimulation Syndrome (OHSS) if fertility drugs overstimulate the ovaries. OHSS involves swollen, painful ovaries and can result in fluid accumulation in the abdomen, ranging from mild symptoms like bloating to severe complications such as rapid weight gain, severe abdominal pain, or blood clots. While OHSS is more commonly associated with injectable gonadotropins used in IVF, taking any fertility medication incorrectly or in an uncontrolled manner increases risk.
Safe Transition to Fertility Treatment
A safe and effective transition from birth control to fertility treatment requires careful planning and medical supervision. Consulting a healthcare provider or fertility specialist is the first step to discuss family planning goals. They will provide guidance on discontinuing birth control, which often involves simply stopping the pills. For most hormonal birth control methods like pills, patches, or rings, the hormones leave the body within about a week, and ovulation can resume within one to three months.
Some healthcare providers may recommend a “washout period” of a few menstrual cycles after stopping birth control before initiating fertility treatments. This allows the body’s natural hormonal cycles to re-establish, providing a clearer picture of underlying fertility and enabling accurate monitoring during treatment. During this time, it is advisable to begin taking prenatal vitamins, particularly those containing folate, to prepare the body for pregnancy. Medical supervision throughout this transition is important to monitor hormonal levels, track the return of ovulation, and determine the optimal timing for starting fertility interventions.