How Long Does It Take to Get Pregnant After IUD Removal?

The intrauterine device (IUD) is one of the most effective forms of reversible birth control. In fact, it's up to 20 times more effective than birth control pills, the patch, or the ring, according to the American College of Obstetricians and Gynecologists (ACOG).

But what happens when you decide that you want to conceive when you have an IUD? Keep reading to learn about pregnancy after IUD removal, including how soon you can get pregnant after having an IUD.

How Does an IUD Work?

To understand your chances of getting pregnant after IUD removal, it helps to know how they work. There are two main categories of intrauterine devices: the copper IUD and the hormonal IUD. Both are small plastic T-shaped devices that are inserted into the uterus.

• Copper IUD: This device releases copper into the uterus, which interferes with sperm's movement, making it more difficult for the sperm to reach an egg.
• Hormonal IUD: The hormonal IUD releases progestin into the uterus, which thickens cervical mucus and makes it harder for sperm to get through. Continuous daily progestin exposure also thins the uterine lining, which makes the uterine environment less amenable to successful implantation.

But here's the key: Neither of the IUDs provide primary contraception by inhibiting ovulation the way birth control pills do. "This is important because it means that when you place and remove your IUD, your ovulation should not be affected, and you can become pregnant right away following removal," says Selina Sandoval, MD, a complex family planning fellow based in Kansas City.

How Soon Can You Get Pregnant After IUD Removal?

If you hope to get pregnant soon, know that fertility usually returns within the first menstrual cycle following IUD removal. "As soon as the device is taken out by your doctor, you could become pregnant," says Hilda Hutcherson, MD, clinical professor of obstetrics and gynecology at Columbia University Medical Center in New York City.

Because no hormones are involved with the copper IUD, your body doesn't have to readjust; after the device is out, any sperm introduced into the uterus can swim normally through it again.

Along those lines, most people with a hormonal IUD don't stop ovulating, so once the device is removed, they should be good to go in terms of baby-making. Consequently, Dr. Sandoval says there's no need to remove your IUD until you are hoping or willing to get pregnant.

A 2015 pilot study of 69 former IUD users and 42 non-former IUD users found that pregnancy rates at 12 months were similar between the groups. In addition, a 2013 study found similar pregnancy rates after IUD removal in older participants with children.

While most participants achieved pregnancy within a year, the study found that, like non-IUD users, age affected pregnancy rates. For example, 81% of participants under 35 were pregnant in a year compared to 76% of those between 35 and 40 and 50% of those over 40.

How Do IUDs Compare to Other Birth Control Methods?

Unlike an IUD, hormonal birth control methods like the pill, patch, ring, and shot release progestin and sometimes estrogen into the body, which prevents pregnancy by stopping ovulation.

Studies have found that with oral contraceptives, fertility returns around three months after stopping the pill. Since patches and the ring work similarly, you should expect around the same wait.

The wait is generally the longest for those wanting to get pregnant after the Depo-Provera birth control shot. One study found that the average return to ovulation was 170 days (a little over five months) in those who received a 45-milligram dose and 226 days (more than seven months) in those who received a 75-milligram dose. However, it's not uncommon for fertility to take up to a year to return after the shot.

What to Expect After IUD Removal

IUD removal is pretty straightforward and usually only takes a few minutes. Most people are relieved to know it's far easier to remove an IUD than to insert one. After your IUD is removed, it's common to experience spotting, which can last up to a few days. You can usually resume regular activity right away.

Pregnancy Risks After IUD Removal

There are no pregnancy risks associated with previously having an IUD. Fertility often returns quickly after IUD removal, and previous IUD usage is not linked with future pregnancy complications.

That said, while rare, if you become pregnant with an IUD still in place, there is an increased chance of pregnancy complications, including:

• Ectopic pregnancy (a pregnancy that occurs outside of the uterus, often in the fallopian tube)
• Miscarriage
• Preterm delivery
• Chorioamnionitis (amniotic infection)

What If You Don't Get Pregnant Right Away?

If you don't get pregnant immediately after removing an IUD, don't panic. Many factors can impact your fertility, including including your age, lifestyle, family history, and general health. "The process to get pregnant will be different for everyone," says Dr. Sandoval. "This is dependent on other factors that may affect your fertility but should not be affected by your IUD use."

Indeed, it takes the average young couple about four to six months to conceive. After one year of trying, approximately 85% to 90% of couples will get pregnant, says Melissa Esposito, MD, a board-certified reproductive endocrinologist at Shady Grove Fertility Center in the Washington, D.C., area. According to ACOG, about half of healthy couples will get pregnant within six months of trying.

If you're under 35 and haven't gotten pregnant in a year, it's time to talk to a health care provider. If you're in your mid- to late-thirties, you should seek help after six months, and even sooner if you're over 40.

And if you're not 100% sure you're ready to get pregnant after removing your IUD? Make sure you're consistently using a backup form of birth control. The IUD is one of the best possible defenses against unplanned pregnancies, and once it's gone, so is the protection it offers.

Early signs of pregnancy after IUD removal are the same as with any other pregnancy and can include sore breasts, implantation bleeding, fatigue, nausea, and frequent urination.