You’ve been using hormonal birth control for years — perhaps decades — and it’s done its job. But now, you’re considering starting or expanding your family. You may be wondering if your birth control will affect your body’s ability to shift into baby-making mode.
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Can birth control make you infertile? The short answer is no.
“Using hormonal birth control doesn’t affect your ability to have a baby in the future,” says women’s health specialist Miriam Cremer, MD. So, why is there a myth about birth control causing infertility? Dr. Cremer helps clear the air.
Can birth control affect your fertility?
What exactly does it mean to be infertile? Infertility means you’ve been trying to get pregnant for a year but haven’t conceived (gotten pregnant). But that doesn’t mean that you won’t get pregnant.
There are many causes of infertility, such as:
- Polycystic ovary syndrome (PCOS), a hormone imbalance that often interferes with ovulation.
- Uterine fibroids, benign (noncancerous) tumors that grow in the lining of your uterus.
- Endometriosis, a condition where uterine tissue grows outside your uterus.
- Low sperm count, a condition where ejaculate contains fewer sperm than normal.
- Other health issues, such as infections, tumors and autoimmune diseases.
- Unexplained infertility, where healthcare providers can’t identify the reason you can’t get pregnant.
What’s not on the list? Hormonal birth control.
“I talk to a lot of people who worry about this,” Dr. Cremer says. “But hormonal birth control does not affect your fertility.”
It’s possible that being on birth control could hide other health problems that affect your fertility — like irregular periods and symptoms of PCOS and endometriosis. In fact, birth control is often a treatment for those health issues, Dr. Cremer explains.
So, while you’re on the pill (or the patch or the shot, or whatever your hormonal birth control method of choice), it may seem as if everything is in working order. But you might not know if your periods come irregularly or if you have pain from endometriosis until you go off birth control and try to get pregnant.
Does the birth control method matter?
Hormonal birth control contains one or more hormones. Some methods contain estrogen and progestin while others only contain progestin. Some are short-acting, such as birth control pills. Others are long-acting, such as shots, intrauterine devices (IUDs) and implants.
Hormonal birth control options include:
- Birth control pills (estrogen and progestin).
- Birth control shot (Depo-Provera®) (progestin only).
- Implant (Nexplanon®) (progestin only).
- Patch (Xulane® and Twirla®) (estrogen and progestin).
- Vaginal ring (NuvaRing® and Annovera®) (estrogen and progestin).
- Hormonal IUD (Mirena®, Kyleena®, Liletta® and Skyla®) (progestin only).
None of these birth control methods make you infertile or negatively impact your future ability to get pregnant.
“Once the birth control is out of your system, your fertility returns,” Dr. Cremer states.
How long does birth control stay in your body?
Once you remove the birth control or stop taking the pill, it takes one to two weeks for the birth control hormones to leave your body. That’s true for every kind of hormonal birth control except for the shot (more on that in a bit). That means you could get pregnant a few weeks after stopping these birth control methods.
Depo-Provera shot and fertility
With the birth control shot (Depo-Provera), it can take quite a while for your body to start ovulating after your last shot.
“The shots give a large dose of progestin that’s intended to prevent pregnancy for 12 or 13 weeks,” Dr. Cremer explains. “But after stopping the shots, it can take anywhere from three months to over two years for fertility and ovulation to fully return to normal.”
It doesn’t take that long for everyone, she adds, but it’s possible.
IUDs and fertility
An intrauterine device (IUD) is a small T-shaped device your healthcare provider inserts into your uterus. It can stay in place for years, and it’s a very effective form of birth control.
Can an IUD cause infertility?
“This is the one people seem to worry about most,” Dr. Cremer notes. “But as long as your IUD was put in correctly, it shouldn’t lead to fertility problems later.”
In very rare instances, an IUD can become embedded into the tissue of your uterus or cause scarring. But even if this happens and the IUD has to be surgically removed, Dr. Cremer says it’s very unlikely this will lead to infertility.
Choosing the right birth control option
“The important thing to know is that there are many birth control options,” Dr. Cremer says. “Hormonal birth control especially has come a long way in the past 20 years or so. There’s something that will work for everyone, whether you prefer hormonal or nonhormonal birth control.”
If you have questions about birth control or want to make a switch, your healthcare provider can help.
Stopping birth control when you’re ready to get pregnant
If you want to have a baby, you’ll have to go off your birth control, of course.
You don’t need to do a special birth control cleanse. And you don’t need to wait any length of time after going off birth control before trying to get pregnant. But it’s a good idea to take some steps to prepare your body for pregnancy.
That includes things like:
- Taking prenatal vitamins.
- Quitting smoking.
- Reducing stress.
- Eating well.
When you’re planning to become pregnant is a good time to visit your healthcare provider. Together, you can talk about your health history, medications and anything that might affect your ability to get pregnant and have a healthy pregnancy.
And if you’ve been trying to get pregnant for a year without success (or six months if you’re 35 or older), it’s time for a conversation with your Ob/Gyn. They can talk to you about a range of fertility options to help you get pregnant.