How does birth control affect my ability to get pregnant?
Many people wonder if years of birth control use will cause fertility problems later down the road. Well, the good news is that long-term use of any of the different forms of birth control should not affect your ability to get pregnant later in life.
Several research studies have looked at the return of fertility after stopping birth control. A comprehensive review of these studies found that birth control use does not negatively affect a person’s fertility. The study also showed that the percentage of people who were able to get pregnant within one year after stopping birth control was similar to the percentage when people were only using barrier methods like condoms or no birth control at all.
This is great news for anyone who isn’t ready to have a child but wants that option in the future, but it still begs the question of which birth control to use and how to start or stop it when the time is right. Read on to learn more!
How should I start or stop birth control?
The question of timing when it comes to birth control and pregnancy– especially how long birth control can last in your system after you stop taking it–is a common one. Thankfully, your body is naturally equipped to do the work when it comes to flushing out your birth control within days––no special cleanses or medications needed. There’s a reason why providers are always concerned about people using birth control correctly–if these methods stayed in the body for a long time, we wouldn’t be fretting about 1 or 2 days of forgetting to take the pill!
To clarify, this does not mean that normal periods return immediately. It is considered normal to not get a period for a few months after stopping hormonal birth control. These forms of birth control affect your hormonal balance in order to stop ovulation (the release of an egg from the ovaries) and as a result, some people simply need a little more time to adjust. Most research on this has shown that it takes about 2-3 menstrual cycles for periods, and fertility, to fully return to normal.
Starting birth control is even easier–once you’ve decided which is right for you, most can be started anytime that’s convenient. So how does each type of birth control affect fertility? Let’s take a detailed look at each category.
What are the fertility effects of each birth control?
Natural and barrier methods (condoms, diaphragms, spermicide, Phexxi)
It should be easier for people who use natural family planning methods to get pregnant since you already know your menstrual cycle well. And since no hormone changes are involved, fertility stays completely unchanged. In the study review mentioned above, 92% of people were pregnant by one year.
People who use barrier methods like condoms (both male and female), diaphragms, or spermicide, will also see no effect on their fertility since these methods simply create a physical barrier to block sperm from reaching the egg. In this group, 94% of people were pregnant by one year.
Another important benefit to condom use is protection against sexually transmitted infections (STIs). Given how common STIs are and that they can lead to pelvic inflammatory disease (PID) if untreated, this is not something that should be ignored. PID is a preventable cause of infertility.
Combination birth control methods (birth control pills, NuvaRing, Annovera, the Patch)
This is the most common type of birth control used because it’s cheap, convenient, and can treat a variety of other issues in addition to preventing pregnancy.
For most people, ovulation after any of these methods will return within a few weeks, though it can often take up to 3 months. This is regardless of how long you’ve been on your birth control. By one year, studies show a 72-94% pregnancy rate in this group. Importantly, your period can take a little longer to come back than ovulation does (ovulation happens about 2 weeks before a period) so just because you haven’t seen your period yet, doesn’t mean that you can’t get pregnant!
Nexplanon (aka "The Implant")
You can get pregnant soon after this device is removed. Most people start to ovulate again by the end of the first month after removal and can be pregnant after just 2 menstrual cycles. At the one year mark, about 70-95% of people who used the nexplanon will be pregnant.
Intrauterine devices (IUDs including Paragard, Mirena, Kyleena, Skyla)
Like the implant, it’s possible to get pregnant very soon after your provider removes your IUD. Most people will ovulate within one month after removal. For most of these people, pregnancy occurs within six months to a year, with pregnancy rates at 71-96% one year after removal.
Depo-Provera (aka “The Shot”)
The Depo-provera injection is the one outlier when it comes to fertility. People who use Depo may have to wait up to 18 months for normal periods to resume after they've had their last injection. It can sometimes take 10 months or more to ovulate again. One study in 2020 found that on average, it took 5-8 cycles for people to get pregnant after Depo (compared to 2-3 cycles for all other birth control methods). This is why Depo is not recommended for people who are hoping to get pregnant within a year or less.
Starting the conversation early is always helpful
Choosing a birth control to use is a personal decision for each individual and needs to be addressed with a healthcare provider who knows your specific goals and medical history. Make sure to talk to a provider if you’re interested in starting birth control or if you’re planning to start trying to conceive in the next year or two.
