Can Birth Control Cause Infertility?

Woman holding blister pack of birth control pills
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Can birth control harm your fertility? The short answer is no. Women who have used hormonal birth control are just as likely to conceive as women who have never used hormonal contraceptives.

A three-year study of 3,727 participants found that long-term use of oral contraceptives did not affect their ability to have children in the future. In fact, people who had used combined (estrogen and progestin) birth control pills for more than three years were found to be more fertile than the study participants who had used them for less time.

As with oral medications, studies have also shown that there is no impact on future fertility with other forms of hormonal contraceptive, either. Whether you choose a vaginal ring, patch, intrauterine device (IUD), implant, injection, or birth control pills, your ability to get pregnant later in life should not be affected by these methods.

Birth Control Fertility Myths

If hormonal contraceptives don't affect fertility, why is there such a persistent myth that they do? There could be a few reasons.

Fertility Delay

Your menstrual cycles should return within about three months of stopping most forms of hormonal birth control, if not sooner. Even so, depending on the contraceptive used and the individual person, it could take some time for fertility to return. Because of this delay, it may seem like birth control has adversely affected fertility.

There may be a short-term fertility delay of two to six months after a person comes off of oral contraceptives. Rings, patches, IUDs, and implants could also have a transient delay of two to four months before fertility returns once you stop using them.

There may be a longer fertility delay with the birth control shot (Depo-Provera). According to the Food and Drug Administration, it takes 10 months on average to conceive after the last injection. But the time until conception can take up to 31 months—or over two and a half years. A lengthy wait is not the average, but it is important to speak with a healthcare provider about your contraceptive options if you are planning to get pregnant.

In regards to oral contraceptives, a long delay of menses that lasts at least six months is referred to as post-pill amenorrhea. Despite its name, this lack of ovulation (or anovulation) is probably not due to birth control use, but rather an underlying health condition.

Tell your provider if you’re not ovulating after you've stopped birth control pills or if your cycles are irregular or absent. They might want to run some fertility tests.

Masked Health Conditions

Birth control overrides your own body's natural hormonal cycle and creates a "fake" menstrual cycle (often including a "withdrawal bleed" that people may refer to as a period). This medical hormone cycle can mask underlying issues. Even if a person has a health condition that causes anovulation, the birth control cycle can still make it look like they are having regular menstrual cycles.

In other words, if you had irregular periods before starting birth control, you will likely have them again after you stop. Upon discontinuing birth control, you may discover there are other reproductive issues preventing you from getting pregnant.

Some health conditions that could result in anovulation or irregular ovulation include:

  • High stress levels
  • Hyperprolactinemia (excessive production of the hormone prolactin)
  • Hyperthyroidism (an overactive thyroid)
  • Hypothyroidism (an underactive thyroid)
  • Low body weight
  • Obesity
  • Premature ovarian failure
  • Polycystic ovarian syndrome (PCOS)

The longer you wait to address any underlying health conditions, the longer it could take to conceive. If you experience a lack of menstruation, heavy bleeding, or irregular cycles, speak with a healthcare professional.

Endometrial Lining

Another reason people believe long-term birth control use affects fertility has to do with the endometrium and its lining, which is where an embryo would implant during pregnancy. While there is a study that reported on the relationship between endometrial lining and birth control usage, there is no definitive research that suggests fertility issues.

A study published in Obstetrics and Gynecology reported that women who used birth control pills for five or more years were significantly more likely to have thinner endometrial linings. A thin lining could make it difficult for an embryo to implant and result in a pregnancy.

It is important to note, however, that the 137 study patients were already being seen in a fertility clinic and preparing for a frozen embryo transfer. These women were already getting in vitro fertilization (IVF), which means that the results may not apply to people with otherwise normal fertility.

Although the researchers concluded that long-term oral birth control pills may increase the risk of IVF cycle cancellation (due to thin endometrial lining), pregnancy rates appeared to be similar between the groups who had thicker and thinner endometrial linings.

As long as you are able to complete the IVF cycle, the odds of getting pregnant would be around the same as someone who had never used the combined birth control pills.

If You Haven't Gotten Pregnant

You stopped birth control pills, your cycles have returned, but you’re not getting pregnant. Now what? While you may wonder if your birth control pills have affected your fertility, rest assured that this is highly unlikely.

There are many reasons why people may struggle to conceive. Infertility affects 12% of couples, and both men and women can experience fertility problems—whether or not they previously used hormonal birth control.

If you don’t conceive after a year (or six months for those age 35 and older) of trying, don't wait to talk to your provider. Delaying testing and treatment may reduce your odds for pregnancy success.

Preventing Pregnancy Without Hormonal Birth Control

Even though the majority of research shows hormonal birth control doesn't cause infertility, there are other risks and side effects associated with it, and some people simply prefer to avoid it. Does this mean you have no way to prevent pregnancy? Of course not!

You may want to consider barrier method options that can provide an effective way to avoid pregnancy while not interfering with your hormones. These options include contraception like condoms, diaphragms, and cervical caps.

A Word From Verywell

Whether you're wondering what kind of birth control would best lend itself to future family planning or you've just come off birth control, you're likely going to have some questions. While the return of your natural menstrual cycle after hormonal contraception use may be delayed, experts agree that long-term birth control usage is not a cause of infertility, which means that using birth control to avoid pregnancy now will not affect your ability to conceive later. No matter your short- and long-term plans, the best plan of action is always to speak with a healthcare provider.

10 Sources
Verywell Family uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  4. U.S. Food & Drug Administration. Highlights of Prescribing Information: Depo-Provera CI.

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  6. Cleveland Clinic. Anovulation.

  7. Gude D. Thyroid and its indispensability in fertility. J Hum Reprod Sci. 2011;4(1):59–60. doi:10.4103/0974-1208.82368

  8. American Society for Reproductive Medicine. Hypothyroidism and pregnancy: What should I know?

  9. Talukdar N, Bentov Y, Chang PT, Esfandiari N, Nazemian Z, Casper RF. Effect of long-term combined oral contraceptive pill use on endometrial thickness. Obstet Gynecol. 2012;120(2 Pt 1):348-354. doi:10.1097/aog.0b013e31825ec2ee

  10. National Institute of Child Health and Human Development. How common is infertility?

Additional Reading

By Rachel Gurevich, RN
Rachel Gurevich is a fertility advocate, author, and recipient of The Hope Award for Achievement, from Resolve: The National Infertility Association. She is a professional member of the Association of Health Care Journalists and has been writing about women’s health since 2001. Rachel uses her own experiences with infertility to write compassionate, practical, and supportive articles.