Can your choice of birth control impact your fertility in the future?
When it comes to figuring out what effect your birth control has on your fertility, you have to wade through a lot of myth and misinformation. All of the contradictory responses about how contraceptives such as the Pill, the IUD (intrauterine device), and Depo-Provera affect your fertility can be confusing and troubling, especially since it’s natural to wonder what effect years of birth control will have on your body, and how long it will take you to become fertile again. Lucky for you, we’ve took the most reliable advice from the experts to give you what you need to know about different contraceptives’ effects on fertility. The good news is that in most cases you will go back to being as fertile as you would have been had you not been using birth control with no lasting negative effects.
There is a mislead common belief that synthetic hormones in the Pill must negatively affect ovaries and fertility. The notion that ovulation could fail to start after stopping the Pill is not true. Ovulation should begin within weeks, and recent studies show that within a year after going off the Pill 80 percent of women who want to get pregnant will get pregnant (which is the same rate as the general population). Of course, there are some cases where women experience delayed ovulation, but on average there is a rapid return to fertility. In most cases where someone doesn’t get their period for months after stopping the Pill, it can be attributed to underlying factors such as age, weight, or other physiological issues.
Another common concern about the Pill is whether there are lingering effects that might harm a fetus. You can rest easier knowing that numerous studies have shown there is absolutely no increased risk of birth defects for babies who were conceived when their mothers were on or just recently off the Pill.
The Pill actually can benefit your fertility because it lowers your chances of getting uterine and ovarian cancer. The Pill also suppresses the symptoms of endometriosis (where the uterine lining grows outside the uterus) that cause fertility problems.
Many doctors do advise waiting for one or two periods after you go off the pill before conceiving, but that is only to help you keep track of your cycle so you can predict your due date. Even if you go off the Pill and get pregnant before you’ve had a period, a sonogram can help determine how far along you are in your pregnancy.
Other Hormonal Contraceptives
Depo-Provera, a contraceptive that is injected once every three months to prevent ovulation, is a highly effective method of birth control, but it is also the one hormonal contraceptive that can have lingering effects on fertility. It stays in your body for many months, even after you stop getting injections, because it’s deposited in the muscle and takes a while to work its way out. While pregnancy can occur as soon as three months after your shot, research has found that the average time for return to fertility is 10 months after the last shot. The rate of pregnancy for former Depo users is the same as the general population’s after a year and a half.
While there are some other hormonal methods of contraception, there isn’t a lot of long-term data because they are so new. Evidence for the Patch, which delivers a low dose of hormones through the skin, and the Ring, which releases hormones through a small, flexible ring inserted into the vagina, suggests that fertility returns as soon as they are removed from the body. For anyone who will has a Norplant contraceptive implant, once the implants are removed, there is no residual effect on fertility.
Back in the 1980s, IUDs got a bad reputation because it was believed they caused pelvic inflammatory disease (PID), which can lead to infertility. However, it turns out that it is not the device itself that leads to PID, but exposure to STDs. The World Health Organization actually found that when IUDs are given to appropriate patients (mainly women not at risk for STDs), the overall risk of PID is extremely low, with only a slightly increased risk during the first few weeks after insertion.
Fertility returns rapidly as soon as the IUD is removed. The ovary itself is not really affected by the IUD, so within about a cycle the uterus recovers and the effect of the IUD is gone. Conception rates following IUD removal are not significantly different from the rest of the population’s.
There is even a potential fertility benefit of the IUD called Mirena, a levonorgestrel intrauterine system that lasts for five years. It actually may offer some protection against some STDs because it thickens the cervical mucus, preventing bacteria from getting into the uterus.
One important thing to remember, whether you’re on the Pill, the Patch, the Ring, or another form of hormone-altering birth control, is that your birth control can mask symptoms of infertility. Because these birth control methods bring on bleeding that’s not a response to ovulation, you may not notice if you develop irregular or missed periods due to something like some thyroid disorders, premature ovarian failure, the rare onset of menopause before age 40, or polycystic ovary syndrome (PCOS), the most common cause of infertility among American women. If you have notice symptoms including acne, weight gain (especially around the waist), unwanted body and facial hair, and pelvic pain while on hormonal birth control, let your doctor know incase they want to test you for PCOS.
So now that you know the truth about birth control and fertility, here’s what to consider when choosing what method is right for you: how well it works, how much effort it takes, when you want to have children, how much the method costs, and whether you need it to protect you from infection. Your doctor is the best person to discuss these considerations with.