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Dr. K.
Dr. K., MD
Category: OB GYN
Satisfied Customers: 4455
Experience:  Board certified OB/GYN with 20 years of experience.
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I'm 36 years old and starting my first IVF cycle next month.

Customer Question

I'm 36 years old and starting my first IVF cycle next month. My clinic has given me a prescription for birth control pills (Enskyce), which I'm supposed to take for 17 days this month, prior to the IVF. I'm concerned about possible side effects (mainly blood clots, cardiovascular effects, etc). I have never taken birth control pills before.
I asked the nurse coordinator at my clinic if it's necessary to take birth control pills. I told her I'm concerned about the side effects and also mentioned that I sometimes experience heart palpitations, mainly due to stress and nervousness. The nurse coordinator said it would be better to take them to help with scheduling and to regulate my hormones. If I don't take them, it could postpone the start date of my IVF cycle, she said.
I have researched birth control pills and it seems that Enskyce is a third generation birth control pill (containing desogestrel). I found that second generation pills (for example those containing levonorgestrel or norethindrone) have a lower risk of blood clots.
I'm scared of all kinds of fertility medications. Last time I took clomid prior to an IUI procedure I had an ectopic pregnancy after that. I don't know if the clomid had anything to do with that, but some studies have shown an increased risk. So I'm afraid to take medications that are not absolutely necessary. But I can't speak to my RE about these concerns because she doesn't want to waste her time. Her receptionist told me I need to talk to the nurse coordinator to discuss concerns, but the problem is, she barely speaks English. So I'm all alone in this and trying to figure out the medications.
My questions are:
Is there is an alternative birth control pill I could take prior to my IVF cycle that has fewer risks?
How much of a disadvantage is it to skip birth control pills prior to IVF?
I heard that estradiol levels have to be low to be able to start IVF. I don't know what my levels are, but what if they are too high?
Submitted: 4 months ago.
Category: OB GYN
Expert:  Dr.Saleem replied 4 months ago.

Hello and welcome to JA. Dr Saleem here. Will be answering you shortly

Customer: replied 4 months ago.
Thank you for reading my post but I would prefer to get a reply from a doctor with better ratings. I dont know what the process is but please don't reply. Thanks.
Expert:  Dr.Saleem replied 4 months ago.

Well i totally understand your concerns . I would like to explain why it is needed prior to IVF and why is desogen the preferred option.

There are 2 main reasons for taking birth control pills prior to your IVF cycle. First, taking birth control pills prior to a stimulation cycle may help the ovaries respond better to the stimulation medication. Second, taking birth control pills allows flexibility in coordinating your cycle, so that procedures can be planned around your work schedule, trips and when all the necessary professionals are available.

Not just any birth control pill can be used in IVF. Birth control pills vary in the amount of hormones delivered with each pill. For the purposes of an IVF cycle, we use a monophasic type which contains the same amount of hormones in every active pill. Therefore, a consistent level of these hormones is maintained. The birth control pill that we prescribe is Desogen (or its generic substitute). If you prefer, a NuvaRing can be used instead. This is a flexible ring that is inserted vaginally and remains in place while releasing a continuous level of hormones.

Expert:  Dr.Saleem replied 4 months ago.

You can read the it, if not satisfied i will opt out for another expert to help you on this.

Customer: replied 4 months ago.
Thanks but this answer doesn't satisfy me.
Expert:  Dr. K. replied 4 months ago.
Can I help?
Expert:  Dr. K. replied 4 months ago.
You are correct, design has increased risk so asking for a pill with at different progesterone is certainly acceptable. The only reason birth control pills are given is to regulated cycle so retrievals do not occur on the weekends in clinics that do not operate. Days a week. It you do not use them, you run the risk of having your cycle cancelled.
Customer: replied 4 months ago.
Hello Dr. K, how am I supposed to know if you could help?
Customer: replied 4 months ago.
this is true. And I already know that though. My clinic is open 7 days a week. I was more concern about the specifics on the medications instead of why they are given.
Expert:  Dr. K. replied 4 months ago.
I was just asking to see if you needed more help.
Customer: replied 4 months ago.
No thanks. But also I didn't receive answers of my questions.
Expert:  Dr. K. replied 4 months ago.
That's why I asked