Follicle Issues After Birth Control: A Guide for Moms

Follicular issues

Hello Doctor: On July 14th (5 days into my menstrual cycle), I was prescribed the contraceptive pill Qlaira due to an ovarian cyst, with the aim of shrinking the cyst.
I took it for three weeks and stopped on August 3rd.
The next day, on August 4th, an ultrasound showed that the cyst was gone.
The doctor also checked my follicles and noted that I only had 2 or 3, which is quite low.
(a.
I heard that contraceptive pills can suppress egg growth and ovulation; could the low number of follicles be affected by just having stopped the medication?) (b.
How long does it typically take for normal ovulation to resume?) The doctor mentioned that my AMH level is 0.62 and recommended freezing eggs for IVF if I want to conceive.
(c.
Due to financial constraints, I am considering natural conception; can taking DHEA improve the quantity of my eggs? Will it help?) P.S.
I have had two children in the past, but due to remarriage, my current husband has one child.
I successfully conceived naturally last December, but unfortunately, I had a miscarriage in March this year.
I am a mother who urgently wants to conceive.

Ping, 40~49 year old female. Ask Date: 2016/08/05

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, having very few follicles may be due to the contraceptive pills suppressing egg growth and ovulation.
At your age, the number of eggs is relatively low.
It is recommended to try to conceive soon, as taking DHEA will not improve the quantity of eggs.
Wishing you good health.

Reply Date: 2016/08/05

More Info

Understanding follicle issues after discontinuing birth control can be a significant concern for many women, especially those trying to conceive. In your case, it appears that you were prescribed birth control pills to manage an ovarian cyst, which is a common practice. Birth control pills can indeed suppress ovarian function, leading to reduced follicle development and ovulation. Let’s address your concerns point by point.

a. Impact of Birth Control on Follicle Development:
When you take hormonal contraceptives like the pill, they work by providing synthetic hormones that prevent ovulation. This means that the natural hormonal signals that stimulate the ovaries to produce follicles and release eggs are suppressed. After stopping the pill, it is not uncommon to see a temporary decrease in the number of follicles, as your body needs time to readjust to its natural hormonal cycle. The fact that you observed only 2-3 follicles after stopping the pill is likely a reflection of this adjustment period.
b. Timeframe for Normal Ovulation:
The timeline for returning to normal ovulation after stopping birth control can vary widely among women. Some may resume regular ovulation within a few weeks, while others may take several months. Generally, most women can expect their menstrual cycles to normalize within 1-3 months after discontinuing the pill. However, individual factors such as age, overall health, and any underlying reproductive issues can influence this timeframe.
c. Improving Follicle Count and Natural Conception:
Regarding your AMH (Anti-Müllerian Hormone) level of 0.62, this indicates a lower ovarian reserve, which can be a concern for fertility. While DHEA (Dehydroepiandrosterone) supplementation has been suggested in some studies to potentially improve ovarian function and increase the number of follicles, the evidence is not definitive. DHEA is a hormone that can be converted into estrogen and testosterone, and some women have reported improved ovarian response when taking it. However, it is essential to consult with a healthcare provider before starting any supplementation, as they can provide personalized advice based on your medical history and current health status.

If financial constraints make IVF (in vitro fertilization) unfeasible, there are still several natural approaches you can consider to enhance your chances of conception. These include:
1. Healthy Lifestyle: Maintaining a balanced diet rich in antioxidants, regular exercise, and managing stress can positively impact your reproductive health.

2. Tracking Ovulation: Use ovulation predictor kits or monitor your basal body temperature to identify your fertile window, which can help you time intercourse for conception.

3. Consulting a Fertility Specialist: If you have concerns about your fertility, it may be beneficial to consult a specialist who can provide tailored advice and possibly recommend treatments that align with your goals and budget.

4. Consideration of Supplements: In addition to DHEA, other supplements like folic acid, omega-3 fatty acids, and CoQ10 may support reproductive health, but again, discuss these with your doctor.

In conclusion, while the transition off birth control can temporarily affect follicle development, many women do return to normal ovulation within a few months. If you are actively trying to conceive, focus on maintaining a healthy lifestyle, tracking your cycles, and consulting with healthcare professionals who can guide you through this process. Remember, patience and support are crucial during this time, and seeking help from a fertility specialist can provide you with more options tailored to your situation.

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