Intrauterine devices (IUDs) are one of the most effective reversible methods of birth control available. In fact, according to the American College of Obstetricians and Gynecologists (ACOG), they’re up to 20 times more effective than the pill, patch, or ring.
But what if you want to get pregnant with an IUD in place? Read on to find out more about getting pregnant after IUD removal, including how soon after IUD insertion you can get pregnant.
How does an IUD work?
To understand your chances of getting pregnant after IUD removal, you need to know how IUDs work. There are two main types of IUDs: copper IUDs and hormonal IUDs. Both are small, T-shaped plastic rings that are inserted into the uterus.
- Copper IUD: This device releases copper into the uterus, blocking sperm movement and making it harder for sperm to reach the egg.
- Hormonal IUD: Hormonal IUDs release progestin into the uterus, thickening the cervical mucus and making it more difficult for sperm to pass through. Continuous daily exposure to progestin thins the uterine lining, making the uterine environment less conducive to successful implantation.
But here’s an important thing to note: IUDs don’t provide primary birth control by suppressing ovulation like the pill does. “This is important because ovulation isn’t affected during the insertion and removal of the IUD, so you can get pregnant immediately after removal,” says Selina Sandoval, PhD, a researcher at Kansas City-based Multidisciplinary Family Planning.
How soon after removing the IUD can I get pregnant?
If you’re hoping to get pregnant soon, know that fertility usually returns within the first menstrual cycle after the IUD is removed. “Once your doctor removes the IUD, you can get pregnant right away,” says Hilda Hutcherson, M.D., clinical professor of obstetrics and gynecology at Columbia University Medical Center in New York City.
Copper IUDs don’t involve hormones, so your body doesn’t have to readjust, and once the ring is removed, sperm introduced into the uterus can pass through it normally.
In that sense, most people who use hormonal IUDs will still be able to have children after the IUD is removed because ovulation doesn’t stop, so Dr. Sandoval says there’s no need to remove the ring until you want to get pregnant or have a chance to conceive.
A 2015 pilot study of 69 IUD users and 42 non-IUD users found pregnancy rates at 12 months to be similar in both groups. Additionally, a 2013 study found that older participants with children had similar pregnancy rates after IUD removal.
The majority of participants became pregnant within a year, but as with people who didn’t use IUDs, the study found that age affected pregnancy rates: For example, 81% of participants under 35 became pregnant within a year, compared with 76% of those aged 35-40 and 50% of those over 40.
How do IUDs compare to other birth control methods?
Unlike IUDs, hormonal contraceptives like pills, patches, rings and injections release progestins and sometimes estrogen into the body, which help prevent pregnancy by stopping ovulation.
Studies have shown that with oral contraceptives, fertility returns about three months after you stop taking them. The patch and ring work in the same way, so you’ll need to wait about the same amount of time.
For those hoping to conceive after receiving the Depo-Provera contraceptive injection, the waiting period is usually the longest. In one study, the average time to ovulation was 170 days (just over five months) for those who received the 45 mg dose and 226 days (just over seven months) for those who received the 75 mg dose. However, it is not uncommon for fertility to return for up to a year after the injection.
What to watch out for after IUD removal
Removing an IUD is very easy and usually takes just a few minutes. Most people will be relieved to know that removing an IUD is much easier than inserting it. After an IUD is removed, bleeding often occurs and may continue for a few days. You can usually resume normal activities immediately.
When to call your healthcare provider
Contact your healthcare provider if you experience any of the following symptoms after your IUD removal:
- Severe cramps
- Severe vaginal bleeding
- Foul-smelling vaginal discharge
- Fever of 101 degrees or higher
- Dyspareunia
Risk of pregnancy after IUD removal
There is no risk of pregnancy associated with the placement of an IUD. Fertility usually returns quickly after an IUD is removed, and previous IUD use is not associated with future pregnancy complications.
However, although rare, if you become pregnant with an IUD in place, you are at higher risk for pregnancy complications, including:
- Ectopic pregnancy (a pregnancy that occurs outside the uterus, usually in the fallopian tube)
- abortion
- Premature birth
- Chorioamnionitis (infection of the amniotic sac)
What if I don’t get pregnant right away?
Don’t panic if you don’t get pregnant right after removing your IUD. Many factors affect fertility, including age, lifestyle, family history, and general health. “Everyone’s fertility is different,” says Dr. Sandoval. “It depends on other factors that may affect fertility but aren’t affected by IUD use.”
In fact, it takes the average young couple about four to six months to conceive. After a year of trying, about 85% to 90% of couples conceive, says Melissa Esposito, M.D., a board-certified reproductive endocrinologist at Shady Grove Fertility Center in the Washington, D.C. area. About half of healthy couples conceive within six months, according to ACOG.
If you’re under 35 and haven’t gotten pregnant in a year, talk to your health care provider. If you’re in your mid-to-late 30s, you should seek help after six months. If you’re over 40, you should seek help even sooner.
What if you’re not 100% sure you’re ready to get pregnant after IUD removal? Make sure you use a back-up method of contraception. The IUD is one of the best ways to prevent an unwanted pregnancy, but once the IUD is gone, so is its protection.
Early symptoms of pregnancy after IUD removal are similar to any other pregnancy and may include breast pain, implantation bleeding, fatigue, nausea, and frequent urination.
