Should birth control pills be used in IVF?
Birth control pills can be a bad idea for IVF patients with low ovarian reserve
Almost since the very inception of IVF, oral contraceptive pills (OCPs), or birth control pills, have been routinely used to prepare patient for IVF cycles. They, indeed, are perfect tools to control the timing of cycle starts. However, they are "perfect" tools only in women with normal ovarian reserve.
In women with low ovarian reserve, i.e. in women at older ages and in younger women with premature ovarian aging (POA), OCPs are counterproductive, because their function is to suppress ovaries. In women with low ovarian reserve, ovarian function is already severely suppressed, and further suppression would harm their IVF pregnancy chances. OCPs, therefore, should not be used in such women. Like other fertility medications that suppress ovarian reserve, such as gonadotropin-releasing hormone antagonists and long agonists, OCPs can counteract other treatments given to patients to improve their ovarian performance, like androgen supplementation and human growth hormone.
This is a part of the September 2018 CHR VOICE.
Norbert Gleicher, MD, leads CHR’s clinical and research efforts as Medical Director and Chief Scientist. A world-renowned specialist in reproductive endocrinology, Dr. Gleicher has published hundreds of peer-reviewed papers and lectured globally while keeping an active clinical career focused on ovarian aging, immunological issues and other difficult cases of infertility.
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