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How Birth Control Pills Affect Ovarian Reserve and Fertility

The Pill may mask a severely diminished ovarian reserve, but will it permanently affect fertility and getting pregnant? Nope! Here’s the latest research on birth control pills and fertility for women. I also found an interesting study that shows that fertility in women is increased by the over-the-counter vitamin supplement 5-DHEA, which I’ll also describe below.

the pill fertility women

Fertility Cookbook

If you recently stopped taking birth control pills and you want to get pregnant, read The Fertile Kitchen Cookbook: Simple Recipes for Optimizing Your Fertility by Cindy Bailey and Pierre Giauque. The best way to start rebuilding your ovarian reserve and get pregnant naturally is to eat foods that boost and optimize your fertility.

What has your doctor told you about birth control pills and fertility? I welcome your comments below. I haven’t written about The Pill and getting pregnant in seven years of blogging about fertility, and I’d love to hear your thoughts.


Does The Birth Control Pill Decrease Fertility?

I was motivated to learn about birth control pills and fertility because a reader said she is going off The Pill after 20 years. She and her husband want to get pregnant, and she isn’t certain how taking birth control pills for so many years affected her fertility.

If you’re concerned about how birth control pills are affecting your fertility, make an appointment with your gynecologist. The results of research studies do not apply equally to all women because we have different genetics, ages, lifestyles, health issues, and ovaries! The best way to learn how the Pill will affect your ability to get pregnant is to see a doctor in person. You don’t necessarily need to see a fertility doctor for women. A simple pap smear and ovary test is a good place to start (unless you already know you have problems getting pregnant).

Research on The Pill and Fertility

Birth control pills lower a woman’s ovarian reserve. According to this study, available evidence is reassuring that birth control pills do NOT decrease fertility for women (though I couldn’t find those research studies). Generally, doctors advise women to stop taking birth control pills about six months before trying to get pregnant. That is, the usual advice is that women who stop taking the Pill will soon have a regular menstrual cycle, and pregnancy is likely within six months or so.

The focus on this study on birth control pills and fertility is whether The Pill masks long-term effects on a woman’s reproductive status. This research by Dr Kathrine Birch Petersen from the Copenhagen University Hospital in Denmark shows that the Pill suppresses two different types of ovarian reserve, which are reliable predictors of ovarian ageing and onset of menopause.

“Ovarian reserve” describes the ability of the ovary to produce follicles and mature oocytes capable of fertilisation. In other words, the better ovarian reserve, the more likely you’ll get pregnant fast. This study shows that the measurements of two types of ovarian reserve were lower in women who were on birth control pills. Ovarian volume was also significantly less.

The Pill was expected to affect a woman’s fertility. “We expected to find an effect of the Pill,” says Dr Birch Petersen. “But during the project we were surprised at the quantified effect on ovarian reserve parameters as defined by anti-Müllerian hormone, antral follicle count and ovarian volume.” In other words, the effect was more prominent than they expected, even after they adjusted for age, BMI, smoking, maternal age at menopause, maternal smoking during pregnancy, and and prematurity.

the pill and getting pregnant

How Birth Control Pills Affect Ovarian Reserve and Fertility

Birth control pills do not permanently change a woman’s ovaries – but there is a recovery phase. Dr Petersen says measurements of ovarian reserve must be modified in women taking the Pill. “However,” she added, “we do not believe that the Pill changes the ovaries in any permanent way. But we still need to know more about the recovery phase after women stop the Pill. The Pill is unlikely to change the basal ovarian biology of egg depletion – but it certainly changes the appearance of the ovaries.”

Ovaries of women on birth control pills may look old, with small volume, a few small antral follicles and low levels of ovarian reserve. But this may not mean a decrease in fertility for women on the Pill. If you’re trying to get pregnant and have recently stopped taking birth control pills, go to your doctor for regular ovarian reserve assessments. The Pill may mask a severely diminished ovarian reserve, and this is important to recognise.

Are you trying to conceive? Read Preparing to Get Pregnant – A Preconception Checklist.

Fertility and DHEA

5-DHEA (5-Dehydroepiandrosterone) improves a woman’s chances of conceiving because it could affect the quality of a woman’s eggs or the follicles. Adrian Shulman of Tel Aviv University’s Sackler Faculty of Medicine and the Meir Medical Center has found a statistical connection between the over-the-counter vitamin supplement DHEA and successful pregnancy rates in women undergoing treatment for infertility.


5-DHEA fertility pregnant

5-DHEA (5-Dehydroepiandrosterone)

Pure Encapsulations – DHEA Micronized is one type of DHEA supplement sold over the counter. If you’re thinking about increasing your fertility because you want to get pregnant (whether or not you stopped taking birth control pills), consult your doctor or health care practitioner first.

DHEA is a naturally-occurring steroid found in the brain, which plays an important biological role in humans and other mammals. Produced in the adrenal glands, it is also synthesized in the brain. The pharmaceutical version of this molecule is known as Prastera, Prasterone, Fidelin and Fluasterone, and identical generics are widely available over the counter in the United States without a prescription.

Dr Shulman believes that women who are finding little success with fertility treatments such as in vitro fertilization and intrauterine insemination could take the DHEA supplement to improve their chances of conceiving. He recommends that women try DHEA treatment, in conjunction with fertility treatments, for four to five months.

I welcome your thoughts on getting pregnant after stopping birth control pills. I can’t offer medical or health advice, but your experience might help other readers! Please feel free to share.

If you’re trying to get pregnant naturally, read 6 Supplements to Boost Fertility and Help You Conceive.


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Sources: Preconceptional factors in the prediction of fertility and the reproductive lifespan was the source of my information on birth control pills and fertility, and Increasing fertility threefold with DHEA? Was the source of the information on 5-DHEA and getting pregnant.

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