Oral contraceptives and their healing rebound effect. OK for conceiving a child, or What is the withdrawal effect? Rebound effect from a medical point of view

Any planning woman wants to get pregnant as soon as possible, ideally on the first try, that is, in the next cycle. Most people mentally set certain dates for the desired conception, and if pregnancy does not occur during this period, unpleasant thoughts creep in about possible problems and even infertility. In search of answers to your questions, you can turn to friends who have gone through something similar, to online forums, doctors and specialized literature. There is often information from various sources about the mysterious and healing rebound effect that drugs from the group of hormonal oral contraceptives have.

Does the rebound effect promote conception?:

The rebound effect is essentially a withdrawal effect, that is, the female body’s reaction to abrupt withdrawal of the drug. While a woman is taking the medicine, her hormonal levels are under the control of the medicine, the function of the ovaries and the hypothalamic-pituitary system is turned off. After the cessation of intake of the drug into the body, ovulation occurs and, as a consequence, pregnancy.
Counting on the subsequent rebound effect, doctors prescribe the drugs “Yarina”, “Janine”, “Jess”, “Marvelon” and others. As soon as the drug is discontinued, in most women the work of the pituitary gland and hypothalamus resumes, and the ovaries are activated under the influence of a natural surge of hormones. Natural stimulation of ovulation occurs. Thus, the rebound effect will be useful primarily for those women who suffer from endocrine infertility.
It takes couples months or even a year to conceive a child. Therefore, the prescription of oral contraceptives with the expectation of a rebound effect is justified only when the period of active planning exceeds a year.
Before treating infertility with this method, you need to be sure of your husband’s fertility. Therefore, taking a spermogram is one of the mandatory examinations that are included in the set of tests for infertility. Well, in the meantime, there is a forced break in planning, make the most of this time - undergo fluorography, do physical therapy, treat existing diseases, including infections.
The doctor should warn that for some women, taking oral contraceptives has a completely opposite effect. Instead of activating the reproductive system, you can get it inhibited for several months. This is rare, but it does happen.

How to choose a drug to obtain a rebound effect?:

To achieve a rebound effect, doctors usually prescribe second and third generation hormonal oral contraceptives. Their reception continues for 3 months. It is also possible to prescribe third-generation drugs in combination with steroids. This course of treatment lasts 5-6 months. You should not take Diane-35 if you expect withdrawal effects.
To achieve activation of the woman’s reproductive system after discontinuation of the drug, analogues of luteinizing hormone-releasing hormone can be used. The difficulties of such tactics are due to the practical inaccessibility of drugs in this group - their small range and high price.
Which combined oral contraceptive (COC) to choose depends on a number of factors - body weight, age of the patient, estrogen level, the presence of benign formations in the uterus and/or mammary glands, indications of diabetes mellitus, bleeding disorders and other problems.
Progestin contraceptives are suitable for those women who are overweight, have fibroids or fibroadenoma, and have elevated estrogen levels. For low body weight or too painful periods, it is better to use combination drugs.
The doctor must be responsible when choosing an oral contraceptive for the treatment of infertility. If your gynecologist advises you to “take any hormonal contraceptive,” do not count on the positive effect of treatment from such a “specialist.” It is also dangerous to prescribe COCs to yourself in order to achieve a rebound effect. Due to the wrong choice of drug, the already disturbed hormonal levels will aggravate the condition.

Who should not take COCs to achieve a rebound effect?:

In some cases, taking oral contraceptives for the treatment of infertility is not indicated:
- the period of active pregnancy planning is less than 1 year;
- pathological abnormalities in the partner’s spermogram;
- disorders of the blood clotting system: thrombosis, thrombophilia, and so on;
- severe pathology of the heart and blood vessels;
- arterial hypertension (higher than 160/100 mm Hg);
- hepatitis, cirrhosis and other severe liver diseases;
- long-term (over 20 years) history of diabetes mellitus, the presence of diabetic angiopathy;
- smoking more than 15 cigarettes per day, despite the fact that the woman is over 35 years old;
- Presence of pregnancy (before starting to take COCs, pregnancy should be ruled out again).

A woman’s feelings about unsuccessful attempts to conceive are understandable. If for some time everything does not go according to plan, the search for reasons and answers begins. Re-reading numerous information about how to influence conception, you will probably come across the concept “ rebound effect" What kind of beast is this and how effective is it?

What is this?

The rebound effect is called the cancellation effect. Its essence lies in the use of medications that inhibit the functioning of the hypothalamic-pituitary system and, accordingly, reduce the production of hormones. After their cancellation, a natural release of hormones occurs and thus pregnancy is stimulated (in approximately 96% of cases). Most often, for this method of stimulation, doctors prescribe hormonal drugs, such as “Yarina”, “Zhanine”, etc. but like any method, there are features that should be discussed with your doctor.

When to resort to the rebound effect

Since the method involves the use of hormones and is, in a sense, an enhanced measure, the couple must have been planning a pregnancy for at least a year by the time it is used. And constantly, without interruption for treatment and protection. Your partner should and so should you. By the time you need to stop using protection, you should both have completed the necessary treatment. In addition, the doctor must warn about the possible absence of a rebound effect and inhibition of reproductive function for some time.

Second or third generation hormonal contraceptives are prescribed for treatment. The choice of a specific remedy depends on such individual factors as age, weight, sensitivity to the components of the drugs, estrogen level, as well as the presence or absence of extragenital pathologies and diseases. Only a doctor can select the necessary medications; there is no need to try to cure yourself, you can earn yourself even more problems with hormonal disorders.

Contraindications to treatment using rebound effect

• bad spermogram,
• planning pregnancy for less than a year,
• heart disease, thrombosis,
• hypertension,
• diabetes mellitus,
• cirrhosis, hepatitis,
• smoking in high doses and age over 35 years,
• pregnancy.

The use of the rebound effect in the treatment of infertility is quite possible, but you should not rely on the advice of those who have already undergone treatment or on your own intuition. Hormones are no joke, so such treatment must be carried out under the strict supervision of a doctor.

Every year, this type of protection from unwanted pregnancy, such as taking oral contraceptives, is becoming increasingly popular among women of reproductive age. But not many of them know about the existence of the so-called rebound effect. Its essence lies in the fact that after a short period of taking and stopping the OC, a woman’s reproductive system can recover and start working “with renewed vigor,” increasing several times the possibility of natural conception.

Women who have not been able to get pregnant for a long time and have already tried many methods that increase the chances of conceiving, but have not received results, begin to think about whether to resort to a method that causes a rebound effect. But is it really as effective and safe as they say?

Rebound effect from a medical point of view

The rebound effect or withdrawal effect is that from the start of taking oral contraceptives, the natural function of the ovaries to prepare the egg for fertilization is inhibited. This occurs due to the inhibition of the hypothalamic-pituitary system, which, through production, controls the functioning of the ovaries. While taking OCs, the work of the ovaries is suspended, and the sensitivity of receptors to hormones increases in the meantime. When you stop taking the pills, the system for producing female sex hormones is restored, they are released in larger quantities, which significantly increases the likelihood of full maturation and the release of a viable egg from the ovary, ready for fertilization. This state can be compared to natural induction. This method is especially effective for women diagnosed with “”, when the production of their own hormones is not enough to maintain the normal functioning of the reproductive system.

Drugs that can be used to achieve a rebound effect

To obtain a rebound effect, the gynecologist may prescribe one of the following combined oral contraceptives:, or. Other drugs can also be used, their choice depends on the patient’s condition and the results of her tests. All drugs are not the same; although they perform the main function of preventing unwanted pregnancy, they have slightly different compositions and, therefore, have different effects on the body. Therefore, only a doctor who has conducted a gynecological examination and interviewed the woman can make the right choice in favor of one drug over another.

There are certain criteria on the basis of which the choice is made in favor of a particular drug:

• woman's age;
• woman's body weight;
• the body's reaction to drugs and sensitivity to them;
• level of estrogen saturation;
• the patient has diseases such as diabetes mellitus, fibroadenomas in the mammary glands, disorders of blood clotting, and some other diseases.

Combined oral contraceptives are suitable for women who are underweight or have dysmenorrhea – the painful first days of menstruation. If the patient is overweight, has high estrogen levels, has uterine fibroids or fibroadenoma, drugs containing gestagens are more suitable for her. Only a gynecologist can make the right choice to achieve a rebound effect, and taking any oral contraceptive without a doctor’s prescription can lead to hormonal imbalance, disruption of the functioning of many body systems, and sudden weight gain.

Do you really need a rebound effect?

A woman should think about the fact that a rebound effect can help her get pregnant only after 12 months have passed since she started planning for a child. Planning means regular sexual activity without contraception. The couple should have sex every month on the expected days of ovulation. As a rule, a twelve-month period is enough for healthy couples, but if after a year of active “planning” you still haven’t been able to conceive, you can think about using alternative methods and, at a minimum, going to a specialist.

Before experiencing the rebound effect, a woman should familiarize herself with the main contraindications that exist for treatment with this method:

1. The woman is already pregnant.
2. The couple has been trying to conceive for less than 12 months.
3. men have poor performance.
4. A woman over 35 years old smokes more than 15 cigarettes a day.
5. Diseases of the cardiovascular system.
6. Liver diseases such as cirrhosis, acute viral hepatitis.
7. Diabetes mellitus that lasts more than 20 years, or diabetes mellitus with angiopathy.
8. Congenital thrombophilias, risk of thrombosis or deep vein thrombosis.
9. Hypertension with pressure more than 160/100 mm Hg. Art.

Even if a woman has no contraindications and is ready to try contraceptives to achieve a rebound effect, there is no guarantee that it will work. In many cases, when pregnancy has not been possible for more than a year, a more effective course of action is for both spouses to undergo screening for reproductive health problems. Timely treatment, precisely aimed at eliminating a specific problem, will be much more productive than using other less common methods.

Sometimes a long absence of a desired pregnancy can force a woman and her doctor to turn to the most non-standard solutions to the problem. One of them is the use of the rebound effect, a condition that occurs immediately after discontinuation of oral contraceptives (OCs). It is characterized by increased work of the ovaries, which were at rest while taking such drugs. But is stopping the OC a guarantee that pregnancy will occur? And are there any nuances that should be taken into account? Let's talk about this right now.

How to “seize” the moment?

Firstly, not all oral contraceptives are capable of causing a strong response in the ovaries. This can only happen after taking combined contraceptives such as:

• Jess;
• Yarina;
• Janine;
• Marvelon;
• Triquilar;
• Tri-Regol;
• Femoden.

Secondly, for the withdrawal effect to take place, you need to take the OC for at least three months, and in some cases a six-month course is necessary. In addition, there is a category of women whose ovaries continue to function even while taking oral contraceptives, which means that in this case, discontinuation of the drug can occur without any consequences at all.

What happens to the ovaries after stopping OK?

The tablets are designed to “turn off” the work of the ovaries and thereby stop unwanted ovulation. They can also be prescribed with the aim of bringing a woman’s hormonal levels in order. After discontinuation of the OC, the ovaries begin to function intensively, and the chances that ovulation will occur significantly increase. Moreover, not one, but several dominant follicles can mature at once.

Accordingly, the “stimulating” effect is fraught with the conception of multiple pregnancies, since the abolition of combined oral contraceptives can stimulate “superovulation”. It is impossible to predict exactly how many eggs will mature. It remains only to recall that the multiple pregnancies included in the Guinness Book of Records occurred precisely against the background of artificially provoked hormonal changes in the woman’s body.

Opinion of medical specialists

Doctors have different views on treating infertility in this way. As a rule, it is not among the first methods that a doctor can use for successful conception, and there are several reasons for this:

• Firstly, not all doctors have a positive attitude towards the use of oral contraceptives as such. Research shows that in 1/3 of cases of taking OCs, a woman’s hormonal balance is so disrupted that it then takes several years to restore it.
• Secondly, doctors are afraid of triggering “superovulation” and getting pregnant with three or more embryos. In the IVF protocol, by the way, “superovulation” is also stimulated, but there the mature eggs are completely under the control of doctors and only 1-2, in rare cases 3, fertilized eggs out of the total number obtained in vitro will be implanted into the woman’s uterus. During the rebound effect, it is impossible to control the number of embryos, since the entire process occurs outside laboratory conditions.
• Thirdly, the effect of OC withdrawal is not considered particularly effective. Even if it contributed to the beginning of maturation of the dominant follicle, this does not at all guarantee that the capsule will burst and the egg will be able to come out, or that the follicle, having reached a large size, will not begin to regress.

Therefore, most medical professionals prefer to use more traditional approaches to treating infertility first. And, of course, you should not start “treatment” with oral contraceptives without consulting a doctor, because uncontrolled use of drugs can lead to hormonal imbalance instead of the long-awaited conception when they are discontinued.

Reviews

Anna: Don't repeat my mistakes! Two years ago I read on the Internet about the miracle effect and prescribed myself contraceptives, sometimes I took them, sometimes I didn’t. The result is no conception, all the hormones have been knocked down, I can’t restore it for the second year.

Irina: My daughter turned out OK in the second month. Only in my case it was not a treatment, I just drank them as protection. Then the doctor advised me to take a break for a couple of months, and now, the result of the “break” has already gone to kindergarten.

Galina: I got both pregnancies the next cycle after stopping taking OK. Both times they tried to bring my hormones back to normal with these pills, since ovulation did not occur.

Alena: I also took contraceptives, hoping to conceive after the “treatment”, but, alas... Apparently, not my method.

Valeria: No sense. Although I took it for six months. After the withdrawal, ovulation did not even occur, let alone conception.

Maria: Six years ago I decided to get off OK and start planning a child. The doctor warned that we had to wait at least three months, otherwise there was a risk of multiple pregnancy. My husband and I did not heed the warnings and hoped that this would not threaten us. We got pregnant in the second month. At 8 weeks I come for an ultrasound, and there are two fertilized eggs in the uterus!

Natalya: Nothing happened to me after the cancellation. Ovulation improved after three months.

Olga: My folliculometry after the withdrawal showed that several dominant follicles were maturing. This was in the first month, but my husband and I decided not to risk it - with my ICN we would not have been able to endure a multiple pregnancy.

Nina: The doctor advised me to take OK for three months, and then get pregnant while withdrawing. Nothing worked, although the gynecologist said that the effect worked for her other patients.

Elena: Nothing worked out for us. There was no ovulation, the follicular cyst had just matured and that’s all.

Any woman planning a pregnancy a little longer than the term that she mentally set for herself begins to worry very much. For help and advice, you can consult a doctor, on the forum - women who measure basal temperature, you can ask friends who have given birth. Listening to pregnancy planning advice, you can learn for the first time about the magical and mysterious “rebound effect” and its participation in conceiving a child. Let's figure out whether this effect is really so magical and whether it will help you open your own pregnancy calendar soon.

What is the rebound effect, how does it treat infertility?

The meaning of the rebound effect, or withdrawal effect, is the temporary drug “switching off” of the ovaries by inhibiting the hypothalamic-pituitary system, followed by the abolition of drugs to achieve ovulation and pregnancy. In other words, first you are prescribed medications, most often these are combined oral contraceptives (COCs): Zhanine, Yarina, Jess, and others, when taken, the production of your own hormones is inhibited, and the sensitivity of receptors to hormones increases. After stopping taking the pills, in 95% of cases, the work of the hypothalamus-pituitary-ovarian system resumes, natural hormones are released, and thus natural stimulation of ovulation is obtained. It is assumed that in this way the chances of pregnancy in the first cycles after discontinuation of drugs in women are increased.

What should your doctor warn you about?

Before prescribing such treatment, the couple must plan a pregnancy for at least a year. On average, this is the period needed for healthy couples who have unprotected sex to conceive a child. By taking oral contraceptives, you “take away” these three months from your planning. Twelve months before starting treatment should not be in total, but consecutively, without interruptions for temporary contraception and examination, with regular sexual activity on the days of expected ovulation.

During or even before starting to take COCs, it is necessary to check your husband’s fertility - take a spermogram. If necessary, the partner should complete treatment before discontinuing contraceptives. You can use the forced break in planning a new addition to the family to take tests (not hormonal), treat infections, and have fluorography.

The doctor should also warn you about the possible reverse effect of using COCs - not getting an ovulatory cycle “on withdrawal”, but inhibiting the reproductive system for a couple of months.

Selection of drugs to obtain a rebound effect

To obtain a rebound effect, the use of second or third generation oral contraceptives is prescribed for 3 months or third generation drugs with small doses of steroids for 5-6 months. The drug is oral contraceptives, the wrong choice of drugs can disrupt hormonal levels, lead to changes in weight and the functioning of body systems.

Contraindications for infertility treatment using rebound effect

• Planning a pregnancy less than 12 months;
• Poor sperm count in husband;
• Deep vein thrombosis, risk of thrombosis, congenital thrombophilias;
• Serious diseases of the cardiovascular system;
• Hypertension with upper pressure above 160 mm Hg. and lower above 100 mm Hg. Art.;
• Severe liver diseases (acute viral hepatitis, liver cirrhosis);
• Diabetes mellitus with angiopathy or duration longer than 20 years;
• Smoking more than 15 cigarettes per day over the age of 35;
• Pregnancy (OCs are prescribed only if the absence of pregnancy is confirmed)