Birth control pills before fertility treatment
Been prescribed birth control pills before your fertility treatment? It may seem counter-intuitive, but an initial course of birth control pills (or BCPs) is common for many fertility patients. Here’s why.
Birth control pills prevent pregnancy – we all know that. But BCPs before a fertility cycle allow the clinic to control your cycle and your subsequent, pre-stimulation bleed. For fertility patients travelling to another country for treatment, they allow you to book your treatment and trip well in advance, saving you money on costly last-minute flights. Once your bleed is controlled by the birth control pills, the clinic then tells you exactly when to stop them. Your bleed arrives three or four days after that. And you then start your stimulating medication, often on day 2 of that bleed.
Only the combined birth control pill will do. These contain an even dose of synthetic estrogen and progesterone. Progesterone-only BCPs don’t work so well. You’ll need to take the birth control pills for a minimum amount of time – usually 18 days. This means you must start them at least six weeks before a frozen embryo cycle or at least five weeks before an IVF cycle using your own eggs. For donor-egg cycles, five weeks will also do. Any less and the clinic needs to organise your treatment in a different way.
Birth control pills aren’t suitable for all fertility patients. If you’ve got high blood pressure or a history of aura migraines, BCPs may not agree with you. Other medical conditions may also preclude their use. Doctors are sometimes wary of prescribing birth control pills to fertility patients over 40. But as the BCPs are for short-term use only the risk to older patients is often not that great. But speak to your doctor about this.
Since donor-egg fertility patients are often in their 40s, there’s also a non-BCP option you can take. The timing of your bleed pattern in relation to your donor’s estimated egg-retrieval day might allow the clinic to avoid the use of BCPs altogether. Instead, your down-regulation injection (if needed) may be used to start off your treatment cycle. Usually, though, donor-egg recipients will be on BCPs and the timing of that injection in relation to the end date of the BCPs helps brings on the bleed just before you start stimulation. That’s the optimal way to synchronise your cycle with your donor’s cycle.
It’s slightly – very slightly – optimal not to take birth control pills before fertility treatment. A body without made-made hormones is more ‘natural’ than one with them in. But the advantages of using BCPs prior to treatment, particularly those planning IVF trips to other countries in advance, outweigh this.
If you’ve had unsuccessful fertility cycles, there’s a stronger argument for planning follow-up cycles without using BCPs at the start. That applies to IVF and FET cycles, but it’s not so relevant to donor-egg cycles. If birth control pills don’t agree with you, an alternative approach to controlling your cycle before a fertility cycle is to use Norethisterone. This progesterone-only medication works in a different way to BCPs, prolonging your bleed from mid cycle. Since these pills can’t be taken for too long, they are less flexible than birth control pills in terms of planning your treatment well in advance. But they can have less side effects than BCPs.
For fertility patients travelling abroad for treatment, your clinic will advise on the use of birth control pills. Most of the time they are indispensable. Occasionally, they should be treated with caution.