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How Does Birth Control Affect Fertility?

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If you’ve been on birth control for a while and have made the decision that you’re ready to start a family, you may have heard stories about your fertility being negatively impacted after prolonged use of contraceptives. However, this simply isn’t the case — research has demonstrated that contraceptive usage, regardless of type or duration of use, does not negatively impact a woman’s fertility or significantly delay a woman’s ability to get pregnant after termination.

how birth control works

Some of the misconceptions surrounding the impact of birth control on fertility may arise from a lack of understanding about how birth control actually works. Most forms of birth control work by releasing hormones into the bloodstream that will prevent ovulation from occurring, and therefore prevent pregnancy. 

different types of birth control

Oral contraceptives, or “The Pill,” work by altering the natural changes in hormone levels that regulate a woman’s menstrual and ovarian cycles each month. Birth control pills contain low doses of the hormones estradiol and progesterone, which suppress the brain’s release of follicle stimulating hormone and luteinizing hormone that are required to mature and release an egg from the ovaries. Because FSH and LH are not released, ovulation does not occur, and a woman will not get pregnant.

Other types of birth control, such as the patch or the ring, also work by releasing the estradiol and progesterone into a woman’s body and suppressing ovulation, but these hormones are absorbed through the skin or the walls of the vagina, respectively.

Progestin-only birth control, such as the mini-pill, is used for women who can’t use estradiol, and works by thickening the mucus of the cervix so sperm cannot enter the fallopian tubes to fertilize an egg. The birth control injection is another progestin-only method that prevents ovulation.

There are also some forms of long-acting reversible contraception. The intrauterine device (IUD) inserted into the uterus prevents sperm from fertilizing an egg in one of two ways: the plastic, hormonal IUD releases progestin and thickens the cervical mucus, or the copper IUD creates a toxic environment in the uterus that kills sperm. The birth control implant is another long-term birth control method that releases progestin.

fertility after birth control

Because most birth control methods rely on the effects of hormones that can alter ovulation or the environment facilitating fertilization, as soon as these hormones or devices are removed from the body, fertility and ovulation can continue as normal. If you stop taking the pill, the extra estradiol and progesterone leave your body within 24 hours. For the patch and ring, fertility is restored after 1 or 2 days, and for IUDs, fertility returns back to normal around a week after removal.

Two types of birth control can delay fertility after termination of use. For injectable contraceptives, because a large dose of progestin is injected into a woman’s system, it can take longer for the hormones to leave the body and cause a delay in fertility for up to 6 or 9 months. The implant works similarly to the injection, but uses a smaller dose of progestin, and can cause a delay in ovulation for up to 3 months.

Outside of these reasons, if you don’t get pregnant within the first few months after stopping birth control, don’t worry — it could just be natural. The chances of a healthy 30 year-old getting pregnant each month is about 20 percent — these chances are restored once you stop using birth control. 

Plus, your age also affects your fertility — fertility for women begins to decline after age 35. If you are still struggling to get pregnant after trying for one year, or after 6 months if you’re over age 35, come into one of our clinics to speak with a fertility expert about what we can do to improve your chances of getting pregnant. Check out the mate fertility services.

However, regardless of the birth control method, it’s important to remember the effects of contraception are reversible and do not leave a lasting impact on fertility. Before choosing a birth control method, it’s important to speak with your healthcare provider about which option is right for you. 

Gabriel Bogner
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