Birth Control Before IVF

[Moosecake]

Morning all, I’m after some advice on taking birth control before an IVF cycle.

In my previous cycles, I’ve taken Norethisterone from about day 21 to extend my natural cycle as needed. Then had a bleed about 3 days after stopping. That’s then been day 1 of my cycle and baseline scan and meds have gone from there.

New clinic I’m speaking to is pushing birth control pill from I think Day 5 of my natural cycle. Said it is optional but advise it for better results and timing.

Haven’t had a full meeting with doctor yet to hear their reasoning but my concerns are that I’ve read online it’s not recommended for low ovarian reserve. I have low AMH (between 2 and 2.7) and AFC a few weeks ago was 8 at scan. I’m assuming this counts as low reserve? Am 39 also so age not on my side.

My natural cycles are very regular - never more than 2 days out, early or late. Am I right I’m thinking after stopping birth control you’re supposed to have a bleed after a few days? I’m wondering if this will be any more precisely timed than my regular cycle?

In the past I was on a combined pill for about 8 months back to back. Was told to expect a withdrawal bleed when I stopped but never happened. Just got a full normal period 27 days later (exact length of normal cycle). I worry I won’t bleed as they expect me to after taking their birth control and mess up ivf cycle.

Any experiences would be appreciated. Do I trust it and go with it or fight for keeping it natural? If there’s medical benefit I’m happy to (as last cycles obviously didn’t work!) but don’t want to risk ruining a new cycle.

[Tnthketnf]

Hi I had the combined pill for 3 out of my 5 attempts. I think I was starting it on day 3 or 4. For 21 days. Then a bleed arrived and started stimulation on day 2 or 3.

It was prescribed by the NHS clinic with the short protocol as a way to 'calm my ovaries down' instead of long protocol and proper downregulation. My issue was that with my natural cycle I would already have a dominant follicle by day 3 or 4 for which the NHS clinic would cancel a stimulation cycle.

It worked in case of allowing me to go ahead with stimulation. I had normal AMH and plenty of follicles.

When I moved to a clinic abroad they didn't like the pill instead -they prescribed estrogen priming from day 21 for a week before stimulation. This was supposed to avoid the dominant follicle and have all follicles grow at the same time. It didn't avoid the dominant follicle in my first attempt at it and my follicles grew at different sizes.

Anyway I felt the pill worked better for me in terms of follicle numbers and egg numbers but I never managed a positive test , same with the estrogen priming. So no difference in the overall outcome.

[Lilacfi]

Hi, I had norethiterone prior to my egg retrieval and my 1st FET. Our first attempt was negative and when having a consultation after, the consultant (different than previously) said that I didn’t need to be on the pill as I had regular cycles. This meant I started meds after my natural cycle. We had out 2nd FET before Christmas and now we are 6 weeks pregnant. Wishing you luck! Do what you feel is right for your body.

[Moosecake in reply to Lilacfi]

Thank you for the replies. Really helpful to hear different experiences. I had Norethiserone before, I think because I accidentally told my last clinic at very first meeting that I have migraines. I do but not that bad that certain drugs trigger them. I feel they may have avoided birth control because of this and gone with Norethiserone instead but don’t know for sure.

Feel taking birth control is probably fine but I just worry when I keep reading online that it hinders follicles if you have low reserve, which I do 🤨 I’ve been working hard with supplements etc and was really happy with my AFC of 8 at my scan this month (not an IVF cycle month, just done to get in date test). Will be kicking myself if birth control lowers my count on first round but will be very glad if it does help follicles grow evenly. Feels an expensive gamble to try it out and see!!

[Moosecake in reply to Lilacfi]

Congratulations on your positive result Lilacfi 🥳

[DaisyG03]

just my experience, but the round was cancelled when I was put on birth control first. Next round used northisterone and I responded much better. Good luck with whatever you decide x