Most patients are often faced with the confusion of starting their IVF journey only to be told to go home and start birth control. Why would they be starting their fertility journey with a medication that usually helps prevent pregnancy? There are a few main reasons for taking birth control prior to an IVF cycle:

  • It may help ovaries respond better to stimulation
  • It may give opportunity to plan and coordinate your cycle allowing for planned procedures
  • It may decrease the chance of developing cysts prior to starting stimulation medications

When my husband and I started IVF in 2014, I was not expecting the nurse to call and say she was phoning in a prescription for birth control pills. I am a pharmacist, I should understand this! I remember going home that evening with my prescription and feeling defeated. Here I was primed and ready to go, but felt like I was taking ten steps backwards by preventing pregnancy. The next morning I called my IVF coordinator and she explained to me that they wanted my ovaries to “be quiet” before starting the process. I was also told that birth control pills would help with the planning and timIng of my cycle. 

This was a big turning point for me in my journey. I felt very vulnerable and realized that as a healthcare provider I have now become the patient. All my knowledge went out the window. The anxiety and worry began creeping in. I had to ride the storm and wait for my rainbow. 

According to InVia Fertility Specialist Blog, taking birth control pills before starting the ovarian stimulation medications will allow follicles to grow at a similar rate. This leads to a greater number of maturing follicles and may increase the number of eggs that are retrieved. 

Not all birth control pills are made the same. Some are made with different amounts of hormones in each pill. For an IVF cycle it is most common to use what is called “monophasic” birth control pills. This means they contain the same amount of hormone in each pill. This will maintain the same hormone level each day.  The last row of pills will be the placebo pills and contain no hormones. Your provider may instruct you to skip the placebo pills and continue with active pills only.  You will need to follow your clinic’s specific protocol regarding the use of birth control pills.  

Some pharmacist tips include: taking the pill in the evening and with food to help reduce nausea, take at the exact same time each day, do not skip any doses. If you miss a dose, take as soon as you remember. Avoid smoking while taking birth control pills due to increased risk of blood clots.

Although birth control pills are a very common medication used in IVF regimens, it may not be appropriate for all women.  Some women are unable to use it because they may have a certain blood clotting disorder or possibly a low ovarian reserve. In this case specialists may have patients use estrogen patches instead to help the ovaries prepare for stimulation. 

Have you or anyone you have known started an IVF cycle with birth control? How did this impact your journey?

Natasha Stamper is a clinical pharmacist and online fertility coach. She found her love for all things fertility while living in a remote Alaska village navigating her own IVF journey alone. After many miscarriages, two ectopic pregnancies, and one cervical ectopic she had her two miracle babies. Now with over 12 years of clinical pharmacy experience and her own experiences she is so excited to be helping families all over the globe fulfill the dream of making their family complete. You can find her on Instagram at fertility_pharmacist or