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Fertility and TTC After Birth Control

When and how to get pregnant after birth control depends on what type of
birth control you were using. You can get pregnant as soon as your
body is ovulating again.

How soon can you get pregnant after stopping birth control?
This is probably the most asked question about trying to conceive after taking birth control. The answer to this depends on what type of birth control you were using. You can get pregnant as soon as your body is ovulating again.

Getting Pregnant after Taking Birth Control Pills
If you were taking birth control pills, you may begin to ovulate as quickly as two weeks after discontinuing the pill. It is hard to say how long it will take for you to start ovulating again. Some women’s fertility returns as soon as they stop taking the pill and others take a few months. It is not uncommon for the first two to three cycles after going off the pill to be long or irregular. Once your period returns to normal and you are ovulating again, it shouldn’t take you any longer to get pregnant than it would any other woman.

Getting Pregnant after Taking Depo-Provera
If you were using Depo-Provera it may take longer for your cycles to return to normal. Keep in mind that Depo-Provera is designed to be a long-lasting form of birth control. Even though it is intended to help you avoid pregnancy for up to three months, it may actually prevent pregnancy longer. Depo-Provera is a synthetic hormone similar to progesterone. It is designed to keep your body from ovulating, but it also keeps your cervical mucous thick and thins the lining of your uterus to prevent implantation. Because Depo tends to keep the lining of the uterus thin, this is one of the reasons women generally have lighter periods while taking it. In order to get pregnant though, you need to not only be ovulating but you also need to be producing fertile cervical mucous and a thick uterine lining after you ovulate. The reason Depo-Provera is so long lasting is because of the way it works. The levels of DMPA (the synthetic hormone in Depo-Provera) gradually increase over a three week period, at which time they reach their peak levels. After three weeks the DMPA levels begin to decrease exponentially. It may take as long as 200 days before DMPA is completely at of your bloodstream. It may take up to a year after discontinuing Depo-Provera before your menstrual cycles return to normal and it may take as long as two years to get pregnant after stopping Depo-Provera.

Getting Pregnant after Using the Mirena IUD
The Mirena IUD works by releasing levonorgestrel (a synthetic form of progesterone) into your uterus. This causes your cervical mucous to become thick. Thick cervical mucous is difficult for sperm to swim through and blocks sperm from reaching the egg. The IUD also makes the lining of your uterus very thin which keeps the egg from implanting if fertilization should occur. It may also prevent ovulation but in most cases it works by blocking sperm from reaching the egg and by stopping implantation. After having the IUD removed your fertility should return fairly quickly. Most women begin having regular cycles immediately after having the IUD removed, but it is not unusual to have a few irregular cycles before your cycles return to normal. Once you start having regular cycles, your chances of getting pregnant are comparable to women who had not been using any birth control.

How long should you wait to start trying to conceive?
You will be happy to know that it is safe to start trying to conceive as soon as you stop taking birth control; however, you may want to wait until you start having regular cycles before you start trying. This is not something that you have to do and it doesn’t put your pregnancy at risk, but it is often recommended. Waiting until you have a few regular cycles makes it easier for your doctors to date your pregnancy. Likewise, it is also easier to predict ovulation if you have a regular cycle.

Should you finish the pack of birth control pills first or is it okay to stop mid-cycle?
This is entirely up to you. You can stop taking the pill at any time but you may want to finish the pack you are taking first before trying to conceive. Any time you stop taking the pill mid-cycle it can cause you to have breakthrough spotting. This can be annoying to deal with and you may find it easier to just go ahead and finish the pack you are taking and then start trying to conceive.

What if your periods don’t return after birth control?
Your periods happen because of ovulation, so as soon as you ovulate, they will return. And if you do not ovulate then it's unlikely that you have regular menstrual cycles and periods. Depo-Provera prevents ovulation for a long time after the injection, up to 6-9 months. Unless you were taking Depo-Provera, your cycles should return to normal within two or three months. Because it takes a little longer for Depo-Provera to get out of your system, it may take a little longer before you start having normal menstrual cycles. If you start trying to conceive before your period returns, you may have a hard time telling if your period is delayed due to issues from stopping birth control or if you are not getting your period because you are pregnant. Unfortunately, after stopping birth control, it may take some time for your body to get back on track.

You may be get stuck in a sort of limbo as your body tries to regulate itself. You can’t move out of the first half of your cycle until you ovulate. And while you are waiting to ovulate you may start having some of the symptoms of ovulation but not actually ovulate. Some of these symptoms, such as breast tenderness and bloating, are very similar to pregnancy symptoms. This can make things even more confusing by making you feel like you could be pregnant when you are not. It is hard to know when your fertility will return and whether or not you will ovulate first or get your period first. If your period doesn’t return right away, the easiest solution would be to take a pregnancy test every few weeks until your period returns. If your period doesn’t return within six months, you should talk to your doctor.

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