Today, we will expand upon our mention of the use of oral contraceptive pills (OCP) in our fertility treatments. You may ask, "why would you use contraception when I am trying to become pregnant?"
We use OCP’s primarily in patients with POF. In these patients, FSH levels are successfully lowered by the negative feedback from the estrogen in OCP’s. Afterwards, FSH receptors regain their sensitivity to FSH, and the follicles start growing as demonstrating by increased E2. E2 is also known as Estrodiol and is a form of Estrogen which can be used for a number of treatments from postmenopausal symptom alleviation to the prevention of Osteoporosis.
In order to prevent premature ovulation, Progesterone is continuously applied during stimulation in a PPOS protocol. In a PPOS protocol, the Pituitary still secretes FSH and LH in physiological pulsatile patterns. If OCPs are well controlled, FSH and LH will not be over-suppressed. Therefore, Granulosa Cells are not dying, and the ovary will be more sensitive.