Can Birth Control Cause Infertility?

Person discussing birth control with doctor

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Can birth control harm your fertility? The short answer is no. Women who have used 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 two 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 as a vaginal ring, a birth control patch, an intrauterine device (IUD), a birth control implant, or birth control injections, your ability to get pregnant later in life should not be affected by these methods.

Birth Control 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 cycles should return within about three months of stopping 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, it may seem like the birth control has adversely affected fertility.

The three-year study with thousands of participants found that there may be a short-term fertility delay of two to six months after a person comes off of oral birth control. Rings, patches, IUDs, and implants could also have a transient delay of one to three months before fertility returns once you stop using them.

There may be a longer fertility delay with the birth control shot (Depo-Provera). It can take up to 22 months—or almost two years—for your cycles to return after the birth control shot. 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 regard to oral contraceptive, 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 birth control pills or if your cycles are irregular or absent. They might want to run some fertility tests.

Masked Health Conditions

Birth control creates a “fake” menstrual cycle, which can mask underlying issues. Even if a person has a fertility problem that causes anovulation, birth control hormones would still make it look like they have 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 fertility problem preventing you from getting pregnant.

Some health conditions that could result in anovulation or irregular ovulation are

The longer you wait to address any complications, the longer it could take to conceive. If you experience a lack of menstruation, extreme 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 reports 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 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) treatment, 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 the thin 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 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 caused your problems, rest assured that this is highly unlikely.

There are many reasons why you may struggle to conceive. Infertility affects 12 percent of couples, and both men and women can experience fertility problems.

If you don’t conceive after a year (or six months for those age 35 and older), 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, some people still want 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. This includes contraception like condoms or a diaphragm.

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 concerns. Realizing that infertility is not a result of long-term birth control usage should assuage your conscience and help with choosing your options when it comes to pregnancy. The best plan of action is always to speak with a healthcare provider.

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Article Sources
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  1. Mikkelsen E, et al. Pre-gravid oral contraceptive use and time to pregnancy: a Danish prospective cohort study. Human Reproduction. 2013 May;28(5):1398–1405. doi.org/10.1093/humrep/det023

  2. Gemzell-Danielsson K, Inki P, Jensen J, Mansour D. Fertility after discontinuation of contraception. Contraception. 2011 June;84(5):465-477. doi.org/10.1016/j.contraception.2011.04.002

  3. Talukdar N, et al. Effect of long-term combined oral contraceptive pill use on endometrial thickness. Obstet Gynecol. 2012 Aug;120(2 Pt 1):348-354. doi.org/10.1097/aog.0b013e31825ec2ee

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