Does Birth Control Pill (BCP) Suppress Ovarian Follicular Response Or Compromise Egg/Embryo Quality?

Many people believe that using the birth control pill (BCP) can suppress the response to ovarian stimulation. However, this is not true if certain precautions are taken. By overlapping the BCP with a specific medication called an agonist, the response to ovarian stimulation can be optimized, and the quality of eggs can be preserved.

The Role of the BCP and Agonist in Ovarian Stimulation

To understand the interaction between the birth control pill (BCP) and GnRH-agonist, (e.g., Lupron/Buserelin/Superfact/Decapeptyl), we need to first understand how follicles in the ovaries respond to fertility hormones. Pre-antral follicles (PAF) do not have the necessary receptors to respond to follicle-stimulating hormone (FSH). It is important for these follicles to develop FSH-responsive receptors, which happens after exposure to FSH for about 5-7 days. Once the follicles have these receptors, they are called antral follicles (AF) and can properly respond to FSH stimulation during ovarian stimulation. The BCP, as well as prolonged administration of progesterone/estrogen levels, suppresses the FSH levels.

To counteract this suppression, blood FSH levels need to rise artificially before ovarian stimulation begins. GnRH agonists, such as Lupron, Buserelin, or Superfact, can cause a surge in FSH release from the pituitary gland. This surge helps the conversion from PAF to AF, preparing the follicles for optimal ovarian stimulation. When using the BCP to start ovarian stimulation, it is important to overlap it with an agonist for a few days before menstruation begins. This ensures that the early recruited follicles have enough time to develop into AF and respond well to ovarian stimulation.

The Importance of Overlapping the BCP with a GnRH Agonist

To achieve the best response to ovarian stimulation, it is crucial to complete the FSH-induced conversion from PAF to AF before starting gonadotropin treatment. Since the BCP suppresses FSH, it is necessary to cause a rise in FSH levels for 5-7 days before menstruation. This can be achieved by overlapping the BCP with an agonist like Lupron, Superfact, or Buserelin. By doing so, the follicles will have enough time to develop and be ready for optimal ovarian stimulation when the menstrual cycle begins. It is important to follow this approach when launching ovarian stimulation after using the BCP to ensure the best possible outcome.

During the BCP cycle, it is important to follow the prescribed dosage and timing as directed by the healthcare provider. Additionally, it is essential to understand the importance of adhering to the medication schedule during the BCP cycle to ensure proper suppression of the FSH levels and synchronization of the menstrual cycle for optimal results during ovarian stimulation.

Moreover, maintaining a healthy lifestyle and following recommended dietary and exercise guidelines can contribute to the success of IVF treatment. Proper nutrition, regular physical activity, and stress management techniques can positively influence the response to ovarian stimulation and overall fertility health. Read our ebook on the IVF process and success to help you get started.


When starting ovarian stimulation after using the birth control pill, overlapping it with an agonist medication is essential. This helps stimulate the necessary follicle development and optimizes the response to the ovulation stimulator. By carefully managing the timing and medications used, the process can be regulated and controlled to improve the chances of success in IVF treatment.

If you want to learn more about how strategic coordination with GnRH agonists can optimize follicular response and egg quality, turn to Sher Fertility Solutions. Maximizing IVF success through careful medication management will be the challenge. Trust Sher Fertility Solutions for personalized fertility care and support on your journey to parenthood. Contact us today to schedule a consultation and take the first step towards achieving your dream of starting or expanding your family.