Ovulation and Perimenopasual Hormone Testing after Birth Control Pill Use

[questwo1]

I have been on Birth Control pills for many years now into my mid-40's.  I am wondering how long I need to be OFF birth control pills to get an accurate test of my hormone levels (re pre-menopause) and of whether i am ovulating or not.  If I end this current BCP pack and start my period (which has been regular), can the the test for hormones (FHS and estradiol) be done in this first cycle off the pill (ie within 3 - 5 days_ with accurate results or do I have to wait for a few cycles without BCP?  Would these results tell me conclusively (or with what certainty) that I am or am not ovulating? Similarly, if I do an ovulation test starting on day 10 after just stopping the pills and starting my period, would it be an indication of ovulation or again do I need to do this over several cycles.   I am trying to determine whether I can get any more information in a short timeframe on my ovualation to help me decide if I would have a chance to become pregnant since I am faced with deciding whether to have fibroids only removed, or a partial hysterectomy.

[Machelle Seibel, MD]

A. Getting pregnant with one’s own egg in mid 40s is very hard to do.  Chances in general at that time are at best only a few percentage points.  However, it is very possible to receive an egg from another (egg donation) and have as high as a 50% chance of conception.  So if you want to have a baby and can accept another’s egg, just have the fibroids out.  If egg donation isn’t an option, then it is more reasonable to have the uterus removed.  Of course, for some women, that is not something they can accept even if childbearing isn’t in their future.

As to the testing. It is unlikely that accurate blood tests can be gotten just a few days after coming off the pill after many years.  You can wait a week or so and begin to see the correct results.  But it is better to do that and wait another 3 to 4 weeks to have a more realistic idea of the current correct values. An ovulation test midcycle after coming off the pill is probably not a good indicator of whether or not a person will ovulate.  Even if one does ovulate, that doesn’t change the statistics of having a healthy baby.
Machelle M. Seibel, MD