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CONTRACEPTION

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When it comes to conception, the first place to start is to consider the contraception that you’ve been using before deciding that you’re ready to try for a baby. Where some contraceptives such as condoms or diaphragms (barrier methods) have no impact on hormone balance, there are others like the contraceptive injection that can affect how soon you’re likely to conceive once you’ve stopped using them. The longer-acting the method, the longer it is likely to take for your normal fertility to return after stopping the method.

Long-acting reversible methods of contraception (LARC methods) such as the intrauterine device (IUD), intrauterine system (IUS), the implant and injectable methods of contraception protect you from pregnancy for a long time (up to 10 years for some methods), so if you are using one of these methods but plan to conceive in the next year you may prefer to switch to a short-acting method such as condoms for a few months.  You can be reassured that no reversible contraceptive method causes infertility, and many women conceive very quickly after stopping contraception, but delays in conception are common.

If you are still using contraception and can plan ahead, start taking your folic acid  about three months before you stop your method.  This helps to boost your levels of this important vitamin as you may conceive very quickly (folic acid should be taken for three months before conception and for the first three months of pregnancy). It is also important to ensure that you are immune to rubella (German measles); so a good time to have the blood test is about three months before you stop contraception because if you are not immune to rubella, you will be immunised again and then need to avoid pregnancy for three months.

It used to be the case that women were advised to wait three months after stopping the pill to begin trying for a baby, but this is not necessary with modern low-dose hormonal methods; it is safe to conceive immediately after stopping all methods. We’ve broken down the key contraceptive methods below so that you have all the facts on how long it could take for you to conceive once you choose to stop using contraception.

Hormonal methods – contraceptive pills, patches or rings

How long until my fertility returns? Between 1 and 12 months

Hormonal methods of contraception contain either a combination of estrogen and progestogen or progestogen alone. Progestogen is the name given to the manufactured version of the hormone progesterone, a steroid hormone used in the female menstrual cycle that supports gestation in pregnancy. Hormonal methods include the combined pill, progestogen-only pill, contraceptive patch and contraceptive vaginal ring. There is no need to wait for the hormones to ‘get out of your system,’ this can be a time of high fertility immediately after stopping hormonal methods. For some women, ovulation is delayed and cycles can be irregular for up to nine months or longer before normal hormonal imbalance is restored, therefore delaying conception during this time. This particularly applies to women taking the combined (estrogen/progestogen) pill, contraceptive patch or vaginal ring as opposed to the pill containing progestogen only. The estrogen component of the methods tends to block ovulation so for estrogen-containing methods it may take a while for ovulation to re-establish; whereas the progestogen  causes changes in a woman’s cervical secretions blocking the passage of sperm. When you stop hormonal methods, it may take a while for your secretions to return to normal to provide an optimum sperm-friendly environment.

Long-acting contraceptive (LARC)  methods – contraceptive injections, implants, IUD and IUS

These long-acting methods do not rely on you remembering to take them or use the method. There are four methods: contraceptive injections, implants, IUD and the IUS.

Contraceptive injection

How long until my fertility returns? Up to 18 months

This is a type of hormonal contraception, given in the form of an injection every three months. If you’re thinking about trying for a baby then bear in mind that it can take up to a year or more to conceive after the final injection due to the residual effects of this mode of contraception. This includes variations in a woman’s cervical mucus pattern, which can continue taking effect beyond the three-month interval.

If you have been thinking about trying for a baby but are not yet quite ready, then it may be advisable to switch to an alternative method of contraception, such as condoms, to allow the body time to adjust before conception. 

Implant

How long until my body is ready for conception? Approximately 3-12 months

The contraceptive implant is a small flexible tube containing progestogen that is inserted into the arm by a medical professional to stop the release of an egg. It lasts for three years. Like other types of hormonal contraception it affects the cervical mucus. Therefore, it can take some time after it’s been removed for this to return to normal and for the hormonal imbalance to be restored fully quickly.

Intrauterine Device (IUD) also known as the ‘Coil’

How long until my fertility returns? Just a few months

The IUD is a copper-containing‘T’-shaped device that is inserted into the uterus for long-lasting contraception. The copper in the device immobilises sperm. There have been concerns in the past that women fitted with old-style IUDs have an increased risk of pelvic inflammatory disease (PID), something that can subsequently impact upon their fertility, however, these prospective risks are heavily related to a woman’s lifestyle. Any woman fitted with an IUD and in a long-term relationship with one sexual partner is not at a significant risk of PID. As there are no hormones involved, ovulation is not affected and fertility normally returns to normal as soon as the device is removed.

Intrauterine System (IUS)

The IUS is a small T-shaped device which contains progestogen. It thickens cervical mucus and may also prevent ovulation in some women. It may take a while for the secretions to return to normal and can take a few months for normal fertility to be restored.

Removing your contraceptive device

If you are using a contraceptive implant, an IUD or IUS, then when you are ready to start trying for a baby you’ll need to get your doctor to remove the device and your cycles should return to normal immediately or after a few months.

Condoms and other barrier methods

How long until my fertility returns?  Immediately

The condom does not have any effect on future fertility. Having said this, it protects sexual health and therefore when you stop using this form of contraception, you must ensure that you do not expose yourself to the risk of catching a sexually transmitted infection, such as Chlamydia, which could impact upon fertility. Female condoms and diaphragams work as barriers in a similar way. When the method is not used, fertility is restored immediately. 

Sources:

www.fpa.org.uk - ‘Plan to get Pregnant’ by Zita West, pg 15, 2008

http://www.netdoctor.co.uk/ate/womenshealth/206943.html

http://www.nhs.uk/Conditions/contraception-guide/Pages/contraceptive-implant.aspx

http://www.nhs.uk/Conditions/contraception-guide/Pages/the-pill-progestogen-only.aspx

Medical information provided by Zita West, Midwife, Fertility and Pregnancy Expert.

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