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Planning Ahead

The type of birth control you take can affect your plans to conceive.

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Many women ask us when they should go off birth control relative to when they hope to get pregnant

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The type of birth control you use now does matter. If you are currently using birth control and you want to get pregnant in the next year, it is important to know how long the birth control impacts your ability to get pregnant even after you stop using it.

In general, most birth control pills work partially because they stop ovulation by providing the body with hormones like those made by the ovaries. When you stop taking the pill, pregnancy-preventing hormones are usually out of the body in a few days, although it may take a couple of weeks, even months, for your body to return to its normal ovulation/menstruation cycle.

Historically, birth control pill manufacturers developed the medication to mimic a typical menstrual cycle with a period each month. However, some newer forms of birth control reduce the number of periods to four or fewer per year. There’s really no difference than with other forms of oral birth control in terms of future fertility. Once you stop taking them, the hormones leave your system within days. There’s no evidence that indicates that reducing the number of periods will impact your ability to conceive later on.

If you receive Depo Provera shots, it may take up to a year to get the pregnancy-preventing hormones out of your system. Unlike birth control pills, which provide a daily dose of hormones taken orally, the Depo Provera shot provides three months of slowly-released hormones, so it’s going to take more time to get the Depo hormones out of your system. If you are considering getting pregnant within a year’s time, I would not recommend the Depo shot. It is a very effective to way to prevent pregnancy, if, for example, you don’t want to get pregnant for two to three years or so between children.

A hormone-based IUD and the NuvaRing are more similar to the pill as compared to Depo Provera. Once they are removed, the hormones leave the body and ovulation can resume. The non-hormone-based IUD and condoms have no effects on a woman’s ovulation, so once they are no longer used, fertility should return to baseline immediately.

Surprise – irregular periods!
Perhaps you started taking birth control pills at a young age to help with irregular menstrual cycles or for other medical reasons. Because being on the pill usually makes your menstrual cycle regular, it’s important to know that if you had irregular periods before taking the pill, it’s likely you may again after stopping. You may not even remember what the issues with your cycle were, but it could be important to understand the underlying cause of irregular periods once you are actively trying to get pregnant. If your cycle has not returned to a monthly pattern after three to six months of being off hormone birth control, see your healthcare provider.

Other Advice

Birth control is only one part of the equation – here are some additional things to include in your planning process.

  • I always recommend that women who are trying to conceive make sure they are getting the proper daily folic acid intake. Studies have shown that folic acid helps prevent birth defects. The recommended daily intake is 400 micrograms. I suggest that you start taking the 400 micrograms of folic acid during the last month you prevent pregnancy with birth control. That way it will be in your system when you begin trying to conceive.
  • Many women will see a physician or midwife before they attempt conception to discuss their own medical history or their previous pregnancies. If you have had any long-term health issues, whether you’re being treated now or not, or if you had a complicated pregnancy in the past, having a quick conversation with your provider about your pregnancy plans may be helpful to you.
  • Stop smoking.
  • If you have diabetes, asthma, hypothyroidism, or certain other immune disorders it is important to have these under good control before attempting a pregnancy. Other problems such as a heart or lung condition might require a specialist’s care during pregnancy, so it would be good to talk to your care provider before you attempt pregnancy in that case.

For most women, the main things to consider revolve around healthy lifestyle choices, regular exercise, and taking folic acid.

What questions do you have about preparing to conceive?  Use the “Comments” tool below to let us know.

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For more information about services at the U-M Center for Reproductive Medicine, or to make an appointment, visit the Center for Reproductive Medicine website.

Senait Fisseha, MD, JD, is the medical director for the University of Michigan Health System’s Center for Reproductive Medicine.  Her areas of specialty cover all aspects of infertility including: polycystic ovary syndrome, recurrent pregnancy loss, other endocrine disorders resulting in infertility; as well as assisted reproductive technologies such as IVF/ICSI, and gamete and embryo cryopreservation.

 

The University of Michigan Center for Reproductive Medicine brings the expertise of infertility specialists and research scientists together to help each of our clients have access to the latest fertility therapies and technologies available — through one convenient center.  We offer a full spectrum of assisted reproductive technology options, including IVF, fertility preservation, Intrauterine insemination, donor insemination (using donor sperm), and pre-implantation genetics diagnosis.