The effects of contraception on future fertility
Sep 09, 2019

Blog / Fertility

If you’re considering trying to conceive soon, it’s important to choose a method of contraception that matches your plan. Most contraception methods don’t have a long-term effect on future fertility, but some can cause a delay in returned fertility after you stop using them.

It’s also important to remember that while many contraceptives stop ovulation, they don’t press pause on your ovaries. Your eggs aren't being released but they're still ageing with you! We encourage you to consider factors that regularly affect fertility, like age and overall health, when you’re considering your fertility plans. It's also important to look at other risks associated with each contraceptive method before choosing your contraception. Here, we're only discussing how each contraceptive method, used correctly and with no complications, could affect your return to fertility.

Contraception and fertility

Does the the pill affect fertility?

The short answer: The pill doesn’t affect future fertility.

The long answer: The pill (combined contraceptive pill) uses hormones to stop ovulation, as well as thickening the cervical mucus so sperm can’t travel easily to fertilise the eggs.

The pill doesn’t have an effect on future fertility. Many women will return to their natural levels of hormone secretion very quickly after they stop taking the pill — usually within a couple of days or weeks. However, it can take up to twelve months for a normal cycle to return. Studies suggest that between 79% and 96% of women are able to get pregnant within 12 months of going off the pill.

There’s no evidence to suggest that the pill will cause infertility or long-term fertility issues.

Does the morning after pill affect fertility?

The short answer: The 'morning after pill' doesn’t affect long-term future fertility.

The long answer: Similar to the combined contraceptive pill, the 'morning after pill' (emergency contraceptive pill) is designed to prevent pregnancy by delaying or preventing ovulation. This method of emergency contraception has no effect on future fertility. There is no evidence to suggest that the morning after pill affects fertility in any way except by preventing pregnancy in the short-term as intended.

Does the 'Depo' contraceptive injection affect fertility?

The short answer: Contraceptive injections can have lingering contraceptive effects for up to 1.5 years but do not affect long-term future fertility.

The long answer: Depo-Provera™ or Depo-Ralovera™ is a contraceptive injected once every three months. Like other hormonal contraceptives, it works by preventing ovulation. Because it is designed to last longer than the contraceptive pill, the contraceptive injection may not be the best option if you’re hoping to become pregnant fairly soon. Though the injection is unreliable as a contraceptive after three months, it can potentially remain in muscle tissue for much longer. Ten months is the median time it takes to return to fertility. By 1.5 years after the last contraceptive injection, fertility rates are the same in Depo users as in the general population.

Does the contraceptive implant affect fertility?

The short answer: The contraceptive implant (Implanon NXT®) does not affect long-term future fertility.

The long answer: The hormonal contraceptive implant, Implanon, is a small plastic rod inserted into the upper arm that remains effective for three years. Similar to other hormonal contraceptives, Implanon allows a return to normal fertility after removal. Like with the pill, ovulation and fertility can return very quickly, in as few as one or two weeks. Some women take longer to achieve pregnancy after Implanon removal, but long-term fertility is the same as in the general population.

Does the hormonal IUD (Mirena) affect future fertility?

The short answer: The hormonal IUD (Mirena) doesn't affect future fertility.

The long answer: The Intrauterine Device (IUD) is a small contraceptive device that is inserted into the uterus. This hormonal IUD works more like other hormonal contraceptives (the pill or injection). Hormonal IUDs use the synthetic hormone progestin to thicken the cervical mucus, stopping sperm from travelling to the egg and often preventing ovulation.

Like other hormonal methods, most women show a quick return to fertility after using Mirena, and don't experience any long term fertility problems associated with uncomplicated use of the IUD.

Many women voice concerns about infection and Pelvic Inflammatory Disease (PID). In the case of new IUDs, the risk of PID and infection is very low; infection can occur in the weeks following insertion but is usually mild and can be treated with oral antibiotics.

How does female sterilisation affect future fertility?

The short answer: As you would expect, sterilisation (tubal ligation) can have a significant effect on future fertility.

The long answer: Tubal ligation, or sterilisation, is a process by which the fallopian tubes are blocked (using various methods), preventing sperm from reaching and fertilising the eggs. Sterilisation is generally considered a permanent contraceptive, and is only recommended for women who are absolutely sure they don’t want to have children. There is a reversal process for sterilisation, though fertility is not the same following a reversal.

The chance of getting pregnant after a reversal is around 40-70%, depending on age, how long between the sterilisation and reversal, and the method of the original surgery. There will likely be some scarring that will affect fertility. Around 50% of women eventually achieve pregnancy after a reversal. The risk of ectopic pregnancy (when the embryo implants outside the uterus) increases for women who have undergone sterilisation and reversal.

It's important to remember that pregnancy can be achieved using IVF without performing a reversal, as the eggs are retrieved directly from the ovaries. Using IVF, the likelihood of pregnancy after tubal ligation is the same as in the general population.

Contraception and future fertility — our conclusions

Contraception doesn't generally affect future fertility. It’s not something to be afraid of, and you can discuss any concerns you have with us in greater detail so that you know your future pregnancy plans won’t be challenged by contraception.

O&G is a team of obstetricians, gynaecologists and women’s health professionals based in Adelaide, Australia. However, the information in this blog is not a substitute for personal medical advice. We designed it to prepare and guide you, not take the place of a consultation. Always talk to your doctor or call O&G to arrange an appointment.

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