Birth Control: Which One You Were Using and What That Means Now
By the time you’re ready to think about starting a family, you may already have spent 5, 10, even 20 years of your life trying to make sure you didn’t get pregnant. So when it’s time to turn all that effort around, it’s natural to wonder what effect all those years of birth control have had on your body, and how long it will take you to become fertile again.
The good news: “With a few notable exceptions, immediately after you stop using birth control, your fertility will go right back to what it was destined to be,” says Paul Blumenthal, M.D., Professor in the Division of Gynecologic Specialties at Stanford University School of Medicine.
Notice that Dr. Blumenthal did not say that your fertility will go back to whatever it was before you started using the method, and he doesn’t say that it will go back to being perfect. Your level of fertility will depend on many things that have nothing to do with your contraceptives. For example, you are no longer the same age that you were when you began using birth control. There are also numerous health and lifestyle issues that affect fertility. Here’s a rundown of different contraceptives, and what you need to know about how they affect fertility.
If you relied on condoms or a diaphragm for birth control, your return to fertility is as simple as leaving them in your night-table drawer. As a bonus, condoms can actually help your fertility by protecting you against sexually transmitted diseases (STDs) such as chlamydia and gonorrhea, which can lead to infertility.
"Patients have the misconception that when they go off the Pill that it somehow has to wash out of their system before they get pregnant,” says Anne R. Davis, M.D., assistant clinical professor of ob/gyn at Columbia University Medical Center/New York-Presbyterian Hospital. “But there have been lots of babies who were conceived when their mothers were on the Pill, and numerous studies have shown there is absolutely no increased risk of birth defects for those babies.”
As for the notion that it takes several months for ovulation to “kick in” after stopping the Pill—it’s simply not true. According to Dr. Blumenthal, ovulation should begin within weeks. Studies show that within a year after going off the Pill, 80 percent of women who want to get pregnant will get pregnant—a number identical to that of the general population. (As for other hormonal methods of contraception such as the patch and the ring, evidence seems to suggest that fertility returns as soon as they are removed from the body.)
Depo-Provera, a contraceptive injected into a woman’s arm or buttocks once every three months to prevent ovulation, is not intended for women who want to be pregnant any time soon. That’s because Depo-Provera, while a highly effective method of birth control, is also the one hormonal contraceptive that can have lingering effects on fertility. “Even though Depo-Provera stops working reliably as birth control after three months, it persists in your body for many months longer because it’s deposited in the muscle. Once it’s in there, it takes time for it to work its way out,” Dr. Davis explains. Research has shown that the median time for return to fertility is 10 months after the last shot, though pregnancy can occur as soon as three months after. A year and a half after the last shot, the rate of pregnancy for former Depo users is the same as the general population’s.
Intrauterine devices have been making a big comeback in the last few years after a long period in which they were on everyone’s blacklist. When the IUD is removed, the return to fertility is fairly rapid, somewhere between the rate of the Pill and Depo-Provera, according to Dr. Blumenthal.
Whichever birth control method you’ve relied on, the important thing to remember is that once you go off of it, you must be prepared for pregnancy. “We see so many women who go off birth control and didn’t think they could get pregnant quickly, and then boom, they’re pregnant by dinnertime,” says Dr. Blumenthal. Wouldn’t it be nice if it were always so easy?