In Vitro Fertilization (IVF) is a fertility treatment that helps individuals and couples achieve pregnancy. A preliminary step in many IVF cycles involves taking birth control pills. While this may seem counterintuitive, birth control serves specific medical purposes to optimize the IVF process.
Why Birth Control is Used Before IVF
Birth control pills (OCPs) are prescribed before an IVF cycle to regulate and synchronize the patient’s menstrual cycle. These pills contain hormones that temporarily suppress natural hormone production and prevent ovulation. This suppression allows fertility specialists to precisely control the timing of IVF procedures.
Ovarian suppression and synchronization is a key benefit. While a natural cycle typically matures one egg, IVF aims to stimulate multiple eggs to grow simultaneously. By quieting the ovaries with birth control, all follicles can start growing from a similar baseline once stimulation medications begin, leading to a more uniform cohort of mature eggs. This helps to maximize the number of eggs retrieved, increasing the chances of a successful IVF outcome. Additionally, birth control can help prevent the formation of ovarian cysts, which could otherwise delay or interfere with the IVF cycle, and offers practical advantages for both the patient and the clinic, allowing for more efficient scheduling of appointments and procedures.
Typical Duration and Influencing Factors
The duration of birth control before an IVF cycle varies significantly based on individual patient characteristics and the specific IVF protocol chosen. Commonly, patients take birth control pills for 10 to 21 days, though some protocols may extend this period up to 42 days, depending on the clinical strategy.
For instance, in an antagonist protocol, birth control pills might be prescribed to control cycle timing, though stimulation can start without them. Conversely, in a long Lupron protocol, birth control may be used to suppress the pituitary gland before starting stimulation, potentially extending the duration. A patient’s ovarian reserve and how their body naturally responds to hormonal changes also influence the decision. For example, some women with diminished ovarian reserve may not be prescribed birth control, as it could further suppress their ovaries. Clinic scheduling and logistical considerations also factor into the planned duration, allowing for better coordination of laboratory and staff resources.
Transitioning from Birth Control to IVF Stimulation
After completing birth control pills, patients typically experience a withdrawal bleed, which is similar to a menstrual period. This bleed usually occurs a few days after stopping the pills, often around day 3 or 4. This withdrawal bleed signals the start of a new cycle, considered Day 1 for the IVF stimulation phase.
The ovarian stimulation phase begins on day 2 or 3 of the bleed. During this phase, patients start injectable fertility medications, known as gonadotropins, such as Follistim or Gonal-F. These medications contain hormones like FSH and LH, which stimulate the ovaries to produce multiple follicles, each containing an egg. Throughout the stimulation phase, which typically lasts 8 to 14 days, progress is closely monitored with regular ultrasounds and blood tests. Ultrasounds visualize and measure growing follicles and assess the uterine lining, while blood tests track hormone levels, ensuring optimal follicle growth and determining precise timing for egg retrieval to maximize the chances of obtaining a good number of mature eggs.
Patient Considerations During the Birth Control Phase
During the birth control phase, patients may experience mild and temporary side effects, similar to regular oral contraceptive use. These can include nausea, headaches, breast tenderness, and mood changes. Spotting or irregular bleeding may also occur, but is generally not a cause for concern and does not indicate an issue with the cycle.
Patients must adhere strictly to the prescribed regimen, taking birth control pills consistently at the same time each day. Missing doses can disrupt the cycle regulation, potentially impacting the timing and effectiveness of subsequent IVF steps. Patients should communicate any concerns or unusual symptoms to their medical team. Fertility clinics provide guidance on when to contact them for side effects or missed pills. This open communication ensures that any issues can be addressed promptly, helping to keep the IVF cycle on track and providing reassurance to the patient.