How Birth Control Could Affect Your Fertility

Here’s the problem: There’s an awful lot of misinformation out there. Scan the Internet or even ask a random sampling of medical professionals, and you’re bound to get contradictory responses about how contraceptives such as the Pill, the IUD (intrauterine device), and Depo-Provera affect your fertility. To set the record straight, we asked experts for the latest, most up-to-date information. The good news: “With a few notable exceptions, immediately after you stop using birth control, your fertility will go right back to what it was destined to be,” says Paul Blumenthal, M.D., professor of obstetrics and gynecology at Johns Hopkins University Medical School in Baltimore and an adviser to the Planned Parenthood Federation of America.

Notice that Dr. Blumenthal did not say that your fertility will go back to whatever it was before you started using the method, and he doesn’t say that it will go back to being perfect. While in most cases you will go back to being as fertile as you would have been had you not been using birth control, that level of fertility still depends on many things that have nothing to do with your contraceptives. For example, you are no longer the same age that you were when you began using birth control. If you were 25 when you began taking the Pill or using a diaphragm, and you are 35 now, your chances of getting pregnant in the first year of trying will have gone down. There are also numerous health and lifestyle issues that affect fertility. Here’s a rundown of different contraceptives, and what you need to know about their effects on fertility.

Barrier Methods
If you relied on condoms or a diaphragm for birth control, your return to fertility is as simple as leaving them in your night-table drawer. “Barrier methods only work while they are on the body or in the body,” Dr. Blumenthal points out. As a bonus, condoms can actually help your fertility by protecting you against sexually transmitted diseases (STDs) such as chlamydia and gonorrhea, which can lead to infertility. (If you relied on natural family planning, in which you pay close attention to your cycle and only have intercourse on “safe” days of the month, you’ll have the added benefit of already being aware of your ovulation cycle once you want to get pregnant.)

Even with these basic methods of birth control, however, doctors still advise you to check in with your ob-gyn before you begin baby-making in earnest. “Around six months before they want to get pregnant, women should check in with their doctor to get necessary blood tests, update their immunizations, start taking vitamin supplements, and discuss changes like quitting smoking and losing weight, if necessary,” says Hilda Hutcherson, M.D., an assistant professor of ob-gyn at Columbia University Medical Center/New York-Presbyterian Hospital in Manhattan.

The Pill
Talk to five different women about oral contraceptives, and you’ll get five different opinions about what sort of effect they have on fertility. Some women swear their years on the Pill made their cycles regular and ultimately helped them conceive. Others are convinced that all those synthetic hormones must have wreaked havoc with their ovaries. Jane Kikuchi’s story is one doctors hear all the time: “I was worried it would take a while to get pregnant after being on the Pill for 12 years,” says the 37-year-old clothing designer in New York. “But literally days after having my period for the first time without the Pill, I got pregnant. I was shocked—it took me a few months to mentally adjust to the idea of being pregnant.”

Still other women worry so much about how lingering effects of the Pill might harm their fetus that they use a condom for months before attempting to get pregnant. “Patients have the misconception that when they go off the Pill that it somehow has to wash out of their system before they get pregnant,” says Anne R. Davis, M.D., assistant professor of ob-gyn at Columbia University Medical Center/New York-Presbyterian Hospital. “But there have been lots of babies who were conceived when their mothers were on the Pill, and numerous studies have shown there is absolutely no increased risk of birth defects for those babies.”