North American Registry of Midwives (NARM) Practice Exam

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What is the main action of combination oral contraceptive pills to prevent pregnancy?

Blocking sperm from reaching the egg
Suppressing ovulation through FSH and LH suppression
Thickening cervical mucus
Altering endometrial lining to prevent implantation

The correct answer is: Suppressing ovulation through FSH and LH suppression

The primary action of combination oral contraceptive pills in preventing pregnancy is the suppression of ovulation. These pills contain synthetic forms of the hormones estrogen and progestin, which work together to inhibit the production of follicle-stimulating hormone (FSH) and luteinizing hormone (LH). This hormonal suppression is crucial because LH is responsible for triggering ovulation; without its peak, the ovary does not release an egg for fertilization. In addition to suppressing ovulation, combination oral contraceptives also contribute to other mechanisms of action that enhance their effectiveness. For example, they can thicken cervical mucus, making it more challenging for sperm to enter the uterus. Furthermore, they can alter the endometrial lining, which could potentially prevent a fertilized egg from implanting. However, the primary and most significant mechanism remains the suppression of ovulation, as this directly prevents the possibility of pregnancy by ensuring no egg is released for fertilization.