Birth control pills effect on fertility

Whether it’s your first-time using birth control pills, or you have been taking it for quite some time, you may have wondered at one point or another – do birth control pills affect your natural fertility?

One common misconception about contraceptives is that they affect a woman’s natural fertility because they might mess up the ovaries’ ability to produce healthy eggs for pregnancy or IVF. Infertility with the use of birth control pills is a frequent concern of women who have plans to conceive in the future.

After taking contraception pills for a certain period of time, you can still get pregnant once the birth control hormones are no longer in the body. However, the period of adjustment and the process of the fertility hormones returning to normal levels varies for each woman.

Birth control pills effect on fertility

Does birth control affect fertility later in life?

The effect of birth control pills on fertility is a common concern among women but experts believe that long-term use of birth control pills does not normally affect to your ability to get pregnant.

The hormones in birth control pills stay in the body for a short time, which is the reason why is has to be taken daily to be effective. Once the usage of birth control pills is stopped, you should be able to conceive again.

However, users of Depo-Provera or DMPA may experience disruptions in ovulation and fertility longer than users of birth control pills. It may take up to six to 12 months after the last shot for the cycles to normalize. In some cases, women may experience fertility and ovulation disruptions for up to 18 months.

Make sure to let your healthcare provider know of any plans to start a family so other alternatives for birth control can be considered.

NHS on pregnancy and birth control pills

According to the UK NHS, it is highly unlikely for birth control pills to cause infertility (1). In fact, you may be able to conceive immediately after stopping the intake of birth control pills.

Even though birth control pills do not cause fertility problems, these can mask underlying medical conditions such as irregular periods or PCOS.

Pregnancy after stopping birth control pills

If you are planning to get pregnant, it is highly recommended to plan for pregnancy before you stop taking birth control pills. This will give you ample time to prepare for conception physically, mentally, and emotionally.

Does I-Pill affect future pregnancy?

I-Pill, otherwise known as the “morning-after” pill, is an emergency contraceptive tablet used after unsafe intercourse or failure of contraception within 24-72 hours of unprotected sexual contact.

Using the I-Pill will not affect a female’s ability to conceive in the future. Keep in mind that it is not a recommended form of birth control because it is not as effective as birth control pills, IUDs, patches, etc. Regular use of the I-Pill may cause unpredictable or irregular periods.

Birth-control infertility statistics

According to a South-West England study (2) that involved 8,497 couples who were trying to conceive after the female partner was exposed to long-term contraceptive use.

Of the study participants who had been on birth control pills:

  • 74% conceived in ≤6 months
  • 14% conceived in 6–12 months
  • 12% conceived after 1 year

Out of 8,497 planned pregnancies:

  • 70.6% had conceived intentionally
  • 29.4% had conceived accidentally
  • 1% had no specific response

In fact, the study revealed that prolonged use of contraception was associated with improved fertility, independent of other factors. Women who have prolonged exposure to the use of oral contraceptives might find these results reassuring that there are no significant disadvantages, specifically about taking the time to conceive after the termination of use.

In the same study, it was established that prolonged use of birth control pills may provide a protective effect on a woman’s fertility by significantly reducing the harmful effects of endometriosis and enhancing iron stores in the body.

Previous studies have suggested that using oral contraceptives may adversely affect a woman’s fertility, but experts are now saying that those studies only considered the fertility levels immediately after the woman stopped taking the pill. According to several other studies, within three months your fertility returns to its normal levels and this is corroborated by the findings of this UK study.

Is there a doctor-prescribed birth control to get pregnant?

A study published in the Fertility and Sterility Journal (3) in April 2000, concluded that the period of anovulation provided by birth control pills enhances the success of IVF treatment.

Anovulation may provide enhanced conditions for the development of a healthy egg and an increased potential for pregnancy up to two menstrual cycles later.

Do birth control pills affect egg quality?

Women taking birth control pills have fewer structures in their ovaries that can promote the maturation of viable eggs. This is understandable because it only means that the birth control pills are doing their job, which is to suspend the egg maturation process at an earlier stage.

However, it doesn’t mean that birth control pills affect egg quality. Once the usage of birth control pills is terminated, conceiving is possible in a matter of months.

Can long-term use of birth control cause miscarriage?

While several studies have shown that birth control pills have little to no effect on natural fertility, long-term usage of these might increase the risk of a potential miscarriage. In a comparative study (4) published in Fertility and Sterility in 2005, researchers found that the consumption of oral contraceptives for a period longer than 2 years, led to a higher risk of miscarriage.

There are various studies published in international journals that link spontaneous miscarriage to changes in local factors in the endometrium, such as cytokines or immune cells. These studies show that when taken for a long period, low-dose oral contraceptives may cause endometrial atrophy with amenorrhea as its main manifestation. This endometrial atrophy increases the risk of miscarriage.

However, birth control pill usage alone is not the only factor for miscarriage; age, lifestyle, health conditions, weight, BMI, and other external factors also need to be considered.

Conclusion: Do birth control pills affect your natural fertility?

The use of birth control pills, or any contraceptive for that matter, does not have a negative effect on your ability to conceive after cessation of their use.

Appropriate counseling and patient education are essential to ensure that women understand the benefits and implications of using birth control pills in their best interest.

For more information and to discuss the usage of birth control pills and their effects on your natural fertility with a qualified doctor, get in touch.

References:

  1. Natural family planning (fertility awareness) -Your contraception guide https://www.nhs.uk/conditions/contraception/natural-family-planning/
  2. Farrow, A., Hull, M. G., Northstone, K., Taylor, H., Ford, W. C., & Golding, J. (2002). Prolonged use of oral contraception before a planned pregnancy is associated with a decreased risk of delayed conception. Human reproduction (Oxford, England)17(10), 2754–2761. https://doi.org/10.1093/humrep/17.10.2754
  3. Misao Fukuda, M.D.; Kiyomi Fukuda, M.D.; Claus Yding Andersen, Ph.D.; Anne Grete Byskov, Ph.D. Does anovulation induced by oral contraceptives favor pregnancy during the following two menstrual cycles? DOI: https://doi.org/10.1016/S0015-0282(99)00631-7
  4. García-Enguídanos, A., Martínez, D., Calle, M. E., Luna, S., Valero de Bernabé, J., & Domínguez-Rojas, V. (2005). Long-term use of oral contraceptives increases the risk of miscarriage. Fertility and sterility83(6), 1864–1866. https://doi.org/10.1016/j.fertnstert.2004.11.085

Other references:

Girum, T., Wasie, A. Return of fertility after discontinuation of contraception: a systematic review and meta-analysis. Contracept Reprod Med 3, 9 (2018). https://doi.org/10.1186/s40834-018-0064-y

Does Birth Control Affect Fertility Long-Term? https://www.bmhsc.org/blog/does-birth-control-affect-fertility-long-term

Alexandra Farrow, M.G.R. Hull, K. Northstone, H. Taylor, W.C.L. Ford, Jean Golding, Prolonged use of oral contraception before a planned pregnancy is associated with a decreased risk of delayed conception, Human Reproduction, Volume 17, Issue 10, October 2002, Pages 2754–2761, https://doi.org/10.1093/humrep/17.10.2754

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