The use of reversible contraception has significantly increased over the last few decades for a variety of reasons, including ease of access, reduction in costs, patient education, and so on. That being said, many women still have confusion and fears about their fertility once they discontinue their birth control.
Different birth control methods and their estimated return of fertility
Like with most things related to our bodies, there’s no one-size-fits-all answer for how soon pregnancy can occur after stopping birth control. The biggest factor that may influence your body’s return to fertility is what method of birth control you were using.
There are a variety of options available when it comes to short and long-term contraceptives.
Choosing one of these options is personal and comes from a partnered decision with your provider:
Progestin-only pills
Also known as the mini-pill, do not significantly delay fertility and time to pregnancy. Progestin thins the uterus lining and thickens cervical mucus making it less likely to ovulate and hindering sperm from reaching a potential egg.
Since these pills do not consistently suppress ovulation, the return of fertility varies for each woman. It may take as little as days or it could take months to become pregnant.
On the other hand, combination birth control pills, meaning those that include both estrogen and progestin, can take longer to recover from. These pills stop the communication from the brain to the ovaries, preventing the ovaries from releasing eggs in addition to thinning the uterine lining and thickening cervical mucus. So it could take up to 3 months, or even longer for some, to become fertile again.
Oral contraceptives
Commonly referred to as “the pill”, it can vary depending on what hormones are in the brand you were taking.
Contraceptive skin patches and vaginal rings
Typically affect the body similarly to combination birth control pills – the only difference being the hormones are absorbed through the skin and reproductive tissue respectively. You can most likely expect fertility to return within 3-6 months.
Barrier methods
Such as condoms or diaphragms, physically block sperm from reaching the egg. This form of contraception does not affect your fertility, meaning it does not prevent ovulation so you could get pregnant the next time you have sex if you are in your fertile window!
Depo-Provera
Commonly referred to as “the shot”, is a contraceptive injection given every three months. The injection site acts as a storage bin for progestin. As we have discussed in the previous forms of birth control, progestin thins the lining of the uterus and thickens cervical mucus making it less likely to ovulate and hindering sperm from reaching a potential egg. In three months, your body reaches into that storage bin and replenishes the progestin. Due to the long-lasting reserve, this method of birth control typically takes the longest for cycles to return to normal – up to 18 months.
Tubal ligation
Also known as “getting your tubes tied”, is a surgical procedure usually performed as a permanent means of birth control, but it can be reversed with another surgery should a woman later decide she wants to conceive. Successful conception depends on the extent of damage to the fallopian tubes. It is possible you could conceive after your fallopian tubes are connected again, but you would need to seek medical approval from your doctor before attempting to get pregnant since each woman’s recovery can differ depending on the technique used by the surgeon.
Vasectomy
It is the male’s equivalent of a tubal ligation – it can be reversed also! Just like with a tubal ligation reversal, your partner will want to check with his doctor before resuming sexual activity. The longer the vasectomy has been in place, the lower the likelihood of the vasectomy reversal being effective for conceiving.
Intrauterine devices
Or IUDs, and implantable rods that are inserted in the upper arm, such as Nexplanon and Implanon, require an appointment with a medical professional for removal. There are two different types of IUDs: copper and hormonal. The copper IUD releases copper ions into the uterus acting as a spermicide.
Since this device does not affect your hormones, you can conceive as soon as it is removed and if you are in your fertile window! The hormonal IUD, as well as an implantable rod, releases the hormone progestin into the uterus causing the uterine lining to thin. Much like the mini-pill, it may take as little as days or weeks to become pregnant after removal. Many women notice a return to regular cycles within 1 to 3 months; however, some women may experience prolonged endometrial thinning from the progestin IUD.
“You’ll never know exactly when you’re ovulating unless you test your body’s hormone levels. This kit/app tells you exactly that! You can use apps but those just go off of standard women so anyone slightly abnormal could miss their fertile window using period tracking apps. It puts it into charts for you, has a social media style platform to post questions, and so much more. I conceived first try using this method right off of birth control. I’ll recommend this to anyone.” – Linsina
How long after stopping birth control can you get pregnant?
A recent meta-analysis of 14,884 women who have recently discontinued birth control with the goal of conception was reviewed at length. Of these women, about 11,600 were on oral contraceptives, 2,300 with IUDs, 700 with implants, and 250 with injections. The studies aimed to find what the rate of pregnancy was after one year of discontinuation of the patient’s birth control.
Pregnancy Rate Within 12 Months After Discontinuation
- Oral Contraceptives: 87%
- IUD: 85%
- Implants/Injections: 74%
- Barrier Method: 84-92% (varying research)
Can hormonal birth control cause infertility?
There are many sources and social media accounts that claim that hormonal birth control can cause infertility, especially if used for long periods of time. You can breathe a sigh of relief because there is no significant scientific evidence backing this claim.
Research shows that rates of infertility are about the same between those who have used hormonal contraceptives and those who have not.
What are the side effects of birth control?
If you are using birth control to treat heavy periods, PMS, or acne, some of your symptoms may come back once you stop. The good news is there are many other treatments available (both conventional and alternative) to help cope with these conditions.
Some of the more natural methods for addressing PMS and hormonal acne—like cutting back on refined carbohydrates, exercising regularly, and taking fish oil—may also help improve your overall health and fertility. Before stopping your birth control, we recommend making an alternate plan for how to address these conditions with your doctor.
It’s not uncommon to experience one or more side effects while using hormonal birth control. Some of the more common side effects include headaches, nausea, decreased sexual drive, mood changes, and weight gain. There is a good chance that once you stop your birth control, these symptoms will improve. So, you can look forward to feeling better soon!
What will happen to my period?
With many forms of hormonal contraception, it can take up to a year for your period to become regular again. This is especially true if you stopped bleeding altogether while you were on birth control.
Irregular cycles are common while hormones regulate after stopping birth control. By tracking your period with the Premom app, you can easily identify any patterns. If your period lasts less than 3 days or more than 7 days, your cycle is less than 21 days or longer than 35 days and follows no consistent pattern, your cycle is irregular. But don’t fret – this is common for most women!
Importance of tracking your cycle after stopping birth control
Overall, it is important to know that most women have ovulatory cycles within the first three months after stopping their birth control, unless they were using Depo Provera. This means that once you stop your birth control it is important to start tracking your cycles. You can use ovulation tests, basal body temperature tracking, and cervical mucus analysis together with Premom, the free ovulation tracker app, to understand your cycle patterns and improve your chance of conception.
To put it simply, you will ovulate before starting your first period after stopping birth control. By starting ovulation testing immediately after stopping birth control, you will increase the likelihood of finding your first LH peak. You can assume ovulation will follow your LH peak within 24-36 hours. If you begin tracking right away and time your sex with LH peaks, there’s a chance you could get pregnant before your first period after birth control! If you miss your first ovulation, it could take a while before you ovulate again due to hormonal regulation.
If you have been tracking consistently and are not quite understanding what your body is doing, please feel free to reach out to us in Ask An Expert!
Lastly, if you do discontinue your birth control and do not have a cycle for three months, it is important to discuss this with your personal doctor. Sometimes your provider may need to induce a period to protect you from the risks of unopposed estrogen.
References
- Girum T, Wasie A. Return of fertility after discontinuation of contraception: a systematic review and meta-analysis. Contraception and Reproductive Medicine. 2018;3(1). doi:10.1186/s40834-018-0064-y
- Healthwise Staff. Getting pregnant after stopping birth control. Cham. Published November 27, 2023. Accessed June 18, 2024. https://www.cham.org/HealthwiseArticle.aspx?id=te8132
- Kaunitz A. UpToDate. UpToDate. Published January 19, 2023. Accessed June 18, 2024. https://www.uptodate.com/contents/depot-medroxyprogesterone-acetate-dmpa-formulations-patient-selection-and-drug-administration
- How soon can you get pregnant after stopping birth control? University of Utah Health | University of Utah Health. Published August 15, 2023. Accessed June 18, 2024. https://healthcare.utah.edu/the-scope/health-library/all/2021/08/how-soon-can-you-get-pregnant-after-stopping-birth-control
- Samuels M. When does fertility return after stopping contraceptive use? | SPH. © 2024 Boston University. Published November 16, 2020. Accessed June 18, 2024. https://www.bu.edu/sph/news/articles/2020/when-does-fertility-return-after-stopping-contraceptive-use/
- Birth control methods | Office on Women’s Health. Office on Women’s Health. Published December 9, 2022. Accessed June 18, 2024. https://www.womenshealth.gov/a-z-topics/birth-control-methods
- Yland JJ, Bresnick KA, Hatch EE, et al. Pregravid Contraceptive Use and Fecundability: Prospective Cohort Study.; 2020. doi:10.1136/bmj.m3966
- Penn Medicine Lancaster General Health. (n.d.). When to stop birth control before trying to conceive. https://www.lancastergeneralhealth.org/health-hub-home/motherhood/getting-pregnant/when-to-stop-birth-control-before-trying-to-conceive
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- Girum T, Wasie A. Return of fertility after discontinuation of contraception: a systematic review and meta-analysis. Contracept Reprod Med. 2018;3:9. Published 2018 Jul 23. doi:10.1186/s40834-018-0064-y
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