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Can Birth Control Cause Infertility?

Some women diagnosed with infertility look back at the years they spent preventing pregnancy with hormonal birth control and question, “Can birth control cause infertility?”

Can birth control cause infertility?

Contrary to a popular myth, the pill has no negative impact on fertility. However, it is easy to understand why there are myths about birth control pills causing infertility as some women experience a delay in resuming ovulation and menses following prolonged birth control use. For some women it may take months after stopping birth control for their menses to return.

“When you’re on the pill for many years, the additional hormones can mask ovulatory problems while artificially giving a woman her menstrual cycle,” explains Frank Chang, M.D. (Rockville, MD).  “Changes in your body, like increased body fat content, or stress that could affect a woman’s cycle, are often masked by birth control pills,” Chang adds.

What type of menstrual cycle irregularities might be masked by birth control pills?

One of the benefits of taking the pill is a predictable menstrual cycle. Women often know exactly when their body will start to menstruate. However, if you’re on the pill, it may mask irregularities in your menstrual cycle that could make conception more difficult. Irregularities may include a shorter than normal, longer than normal, or absent cycle altogether. Birth control pills may even mask prolonged menstrual bleeding, which is bleeding that last longer than 5 to 7 days.,

How do birth control pills work?

Most birth control pills use synthetic hormones that are similar to those produced in the female body—estrogen and progesterone. These hormones work together to prevent ovulation by signaling to the brain to decrease production and release of follicle-stimulating hormone (FSH) and luteinizing hormone (LH). FSH and LH are vital in the maturation and ovulation of eggs during a typical menstrual cycle.

The estrogen and progesterone from the birth control pills also cause the uterine lining to become inhospitable for embryo implantation and causing the cervical mucus to be too hostile of an environment for sperm to swim toward the cervix.

When should I stop taking birth control pills if I am trying to conceive?

Whether you have been on the pill for 6 months or 10 years, many women resume a normal menstrual cycle within 1 to 2 months after stopping birth control pills. Once you go off the pill, your body should go back to ovulating. If your menstrual cycle cycle doesn’t resume within 2 months of stopping birth control, contact your Gynecologist.

If a woman under the age of 35 has been unable to conceive after 1 year after discontinuing use of birth control, or if a woman 35 years or older has been trying to conceive for 6 months without getting pregnant, she should consult a fertility specialist.

Why do infertility patients need to take birth control pills?

It may seem counterintuitive but birth control pills are widely used during infertility treatment. For example, before starting in vitro fertilization (IVF), many women will take birth control pills to suppress their ovaries.

“When you’re doing IVF, you want to recruit a lot of follicles [10, 15, or 30], and if you don’t have that suppression in the month beforehand and you start injections, some of the ones that have been recruited already are going to get a head start,” says Chang. “The pill provides the necessary synchronization among follicle growth, increasing the number of mature eggs,” Chang adds.

Shady Grove Fertility physicians also uses the pill to time the start of a treatment cycle, “because we’d like to know, particularly if you don’t have regular periods, when we need to start your treatment cycle,” explains Chang.

Why do women who are freezing their eggs to preserve their future fertility need to take birth control pills?

Similar to during infertility treatment, women who want to freeze their eggs will use birth control pills to help time the start of their cycle and help follicles grow at the same rate. Birth control pills can also be used to manipulate your cycle based on when you want the egg retrieval to take place.

Medical Contribution by: Frank Chang, M.D.


Can birth control cause infertility? No, but if you are having trouble conceiving or interested in learning more, please call Shady Grove Fertility at 1-877-971-7755.

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