Can You Get Pregnant With an IUD?

There’s a very good chance you—or someone you know—has used an intrauterine device (IUD) as birth control. IUDs are growing in popularity, with about 10 percent of reproductive-age women currently using “long-acting reversible contraception,” which includes IUDs.

While IUDs are pretty darn good at preventing pregnancy, you might be wondering exactly how effective they are—especially if you don’t want to have more kids (or any kids). Unfortunately, they’re not totally foolproof. “IUDs can fail,” says Christine Greves, MD, FACOG, an ob-gyn at the Orlando Health Women’s Institute. “It occurs incredibly rarely.”

“I got an IUD put in after my son’s birth, thinking I was set,” shares The Bump community member onnyanne. “He’ll be turning 8 months next week, and I just found out yesterday that I’m 5 weeks pregnant. I never imagined I’d be expecting again so soon… or at all.”

So, can you get pregnant with an IUD? Yes—but rest assured that it’s very unlikely. Ahead, learn all the details from experts, including your chances of getting pregnant with an IUD and what to do if this happens to you.

Key Takeaways

• IUDs are considered one of the most effective birth control methods: They’re 99.2 to 99.6 percent effective at preventing pregnancy.
• While rare, you can get pregnant with an IUD; there are both scientific case studies and anecdotal evidence of this happening.
• Potential risks of being pregnant with an IUD include miscarriage, ectopic pregnancy, preterm birth and infection.
• If you have an IUD and find out you’re pregnant, see your doctor right away. In most cases, they’ll try to remove the IUD.

What Is an IUD?

An IUD is a small, T-shaped device that’s inserted into the uterus to prevent pregnancy, according to the U.S. National Library of Medicine. An IUD has two small strings that hang outside the cervix and within the vagina—these can let you or your doctor check that the IUD’s in place and can also be used to pull the IUD out when it’s time to remove it. An IUD is considered a great option if you’re looking for a long-term, effective and non-hormonal birth control method; it can prevent pregnancy for 3 to 10 years.

Types of IUDs

There are two main types of IUDs, according to the American College of Obstetricians and Gynecologists (ACOG):

• Hormonal IUD. This releases the hormone progestin into the uterus. Each hormonal IUD is slightly different and is approved by the U.S. Food and Drug Administration (FDA) to be used for varying periods of time. While some hormonal IUDs need to be changed every three years, others can last for up to eight years before needing to be replaced.
• Copper IUD. This IUD doesn’t use hormones to prevent pregnancy. Instead, it releases copper into the uterus, which impacts the sperm’s ability to move. The copper IUD is approved for use for up to 10 years before needing to be removed.

Can You Get Pregnant With an IUD?

Yes, it’s possible to get pregnant with an IUD, but it’s far from a common occurrence. “It’s very unlikely,” says Rachael Lopez, MD, an ob-gyn and the medical director of Women’s Services at MemorialCare Saddleback Medical Center’s Women’s Health Pavilion in Laguna Hills, California.

Chances of getting pregnant with an IUD

IUDs are considered one of the most effective birth control methods out there. They’re 99.2 to 99.6 percent effective at preventing pregnancy, according to ACOG. Those are similar success rates to using a birth control implant or male or female sterilization. Over time, long-acting reversible contraception methods like IUDs are 20 times more effective than birth control pills, the patch or the ring, notes ACOG.

But there are certain situations in which pregnancy may be more likely with an IUD. “If the IUD falls out or is in the wrong position—partially coming down into the cervix—pregnancy is more likely,” explains Roxanne Jamshidi, MD, MPH, director of the division of general obstetrics and gynecology at George Washington University School of Medicine and Health Science. Women who are younger, who’ve never had a baby, who have fibroids and who have heavy periods have a greater risk of their IUD falling out, she says, adding that “using an IUD beyond its recommended lifespan also increases failure rates.”

Pregnant With IUD Symptoms

The symptoms of pregnancy with an IUD are similar to what they’d be if you didn’t have an IUD in place, says Jennifer Leighdon Wu, MD, an ob-gyn at Northwell Lenox Hill Hospital in New York City.

These can include fatigue, breast tenderness, morning sickness, cravings and food aversions, constipation, peeing more than usual and a missed period, says Greves. However, she also points out that not everyone has regular periods while using an IUD.

Risks of IUD Pregnancy

There are a few potential risks of being pregnant with an IUD, says Andrew Rubenstein, MD, director of the division of general obstetrics and gynecology at NYU Langone Health. “If the IUD remains in place during pregnancy, there are increased risks of miscarriage and infection,” he says.

There’s also a higher risk of having an ectopic pregnancy, which is a pregnancy that happens outside the uterus—usually in the fallopian tubes, Rubenstein says. “This is a serious condition that needs medical attention right away,” he adds.

Preterm labor and infection are other potential risks.

Next Steps: What to Do If You Have an IUD Pregnancy

If you suspect that you’re pregnant and you have an IUD, Wu recommends taking a pregnancy test. If you get a positive pregnancy test, contact your doctor.

Greves says that next steps are often a “case-by-case situation” depending on how far along the pregnancy is. “Usually we try to remove it, especially if the pregnancy is discovered in the first trimester,” she says.

Jamshidi adds that it’s important for your doctor to locate the pregnancy “since ectopic pregnancy is more common with the IUD in place.”

Real Stories: How I Knew I Was Pregnant With IUD

Again, it’s pretty rare to get pregnant with an IUD, but it does happen.

One case report from 2019 details the story of a 29-year-old woman who got pregnant with a copper IUD in place. During a transvaginal ultrasound, doctors discovered that she had a bicornuate uterus, which is when the uterus is divided into half. The IUD was removed from one side of her uterus, and the pregnancy progressed without complications.

Another case report, from 2011, tells the story of a 22-year-old woman who went to the hospital with vaginal bleeding one week after she got a positive pregnancy test. Doctors ultimately decided to leave the IUD in place and her pregnancy continued.

Please note: The Bump and the materials and information it contains are not intended to, and do not constitute, medical or other health advice or diagnosis and should not be used as such. You should always consult with a qualified physician or health professional about your specific circumstances.