The myth of needing a 'clearance period'
Many people believe they must wait several months after stopping hormonal contraception for their body to "clear" the hormones before trying to conceive. This is largely a myth for most methods. For short-acting methods like the pill, patch, or ring, the hormones are out of your system relatively quickly, and ovulation can resume in as little as a few weeks. Contemporary research confirms that it is safe to begin trying to get pregnant immediately after discontinuing most forms of contraception. The misconception likely stemmed from older advice intended to help with pregnancy dating by allowing a natural menstrual cycle to occur first. However, with modern dating methods like ultrasound, this waiting period is no longer medically necessary.
How specific birth control methods affect fertility return
Fertility's return depends heavily on the specific method, as each one works differently to prevent pregnancy. Understanding these nuances can help you plan your conception timeline more accurately.
Hormonal birth control pills
- Combination pills: Containing both estrogen and progestin, these pills stop ovulation. Ovulation often returns within one to three months after stopping, and many couples conceive within a year. Your first period after stopping may be a withdrawal bleed, with your natural cycle returning after that.
- Progestin-only pills ('mini-pills'): These pills primarily work by thickening cervical mucus, with ovulation sometimes still occurring. Fertility can return within days or weeks of cessation. This is because the progestin-only effect wears off much faster.
Intrauterine devices (IUDs)
- Hormonal IUD (e.g., Mirena): Ovulation can resume within a month of removal. The return of fertility is rapid, with conception possible in the first cycle after removal. The hormones in these devices are localized to the uterus and do not suppress the body's natural cycle for long.
- Copper IUD (non-hormonal): Because it contains no hormones, fertility returns immediately upon removal. A person could become pregnant during their first fertile window after the device is out. The device's function is physical, not hormonal, so it has no lasting effect on your system.
Contraceptive implant (e.g., Nexplanon)
This matchstick-sized implant releases progestin to prevent ovulation. After a healthcare provider removes it, the hormone levels in your body drop quickly, and ovulation typically resumes within weeks. Conception can occur very soon after removal.
Birth control patch and vaginal ring
These methods, which also contain estrogen and progestin, suppress ovulation. Following discontinuation, ovulation can start again within one to three months. A 2021 study found an average delay of three cycles for rings and four cycles for patches before conception, with fertility rates normalizing to other methods after that initial period.
Birth control shot (Depo-Provera)
This is the most significant exception to the rule of rapid fertility return. The progestin injection can suppress ovulation for a prolonged period, and it may take 10 months or more for fertility to return to baseline after the last injection. For this reason, those planning to conceive in the near future may be advised to choose a different contraceptive method. The drug remains stored in the muscle tissue and is released slowly over time.
Comparison of fertility return timelines by birth control method
| Birth Control Method | Average Time to Return of Fertility | Key Consideration |
|---|---|---|
| Barrier Methods (Condoms, Diaphragm) | Immediate | No hormonal effect, so fertility is unaffected. |
| Copper IUD | Immediate (first fertile cycle) | Non-hormonal; quick return to baseline fertility. |
| Progestin-Only Pill ('Mini-Pill') | Days to weeks | Effect is short-lived; ovulation can resume very quickly. |
| Hormonal IUD | Within 1–2 months | Ovulation often resumes shortly after removal. |
| Implant | Within 1–2 months | Fertility returns to baseline quickly after removal. |
| Combination Pill/Ring | 1–3 months | May take a few cycles for natural menstruation to regulate. |
| Patch | 1–3 months | Similar to the pill, with hormonal effects wearing off quickly. |
| Birth Control Shot (Depo-Provera) | Up to 10–18 months | The longest delay is possible due to the long-acting hormone. |
Preparing for conception after stopping birth control
Beyond the timing, there are other important steps to take when preparing for pregnancy. Taking a proactive approach can help optimize your health for a successful conception and pregnancy.
- Preconception check-up: Schedule an appointment with your healthcare provider. This is an opportunity to discuss your health history, get guidance on potential risks, and ensure you are in the best possible health for pregnancy. They can also advise on your specific contraceptive method and what to expect.
- Start prenatal vitamins: Begin taking a prenatal vitamin with folic acid at least one month before trying to conceive. Folic acid helps prevent major birth defects of the baby's brain and spine and is most effective when taken before pregnancy begins.
- Track your cycle: Once you've stopped contraception, tracking your menstrual cycle can help you identify your fertile window. Look for signs like changes in cervical mucus (which becomes clear and slippery near ovulation) or a slight rise in body temperature (after ovulation). Apps can also assist with this.
- Adopt healthy habits: Maintain a healthy lifestyle by eating a balanced diet rich in nutrients, exercising regularly, and avoiding smoking and alcohol. Manage stress, as high stress levels can also impact fertility.
- Monitor for irregularities: Pay attention to your body as your natural cycle returns. After stopping hormonal birth control, it's common to experience some initial irregularity. However, if you don't get a regular period within three months, or if your cycles are very irregular, consult your doctor.
When to see a doctor
While most couples conceive within a year of trying, certain situations warrant a call to your doctor sooner. If you are under 35 and have been trying for a year without success, or if you are over 35 and have been trying for six months, it may be time for a fertility evaluation. For those over 40, a consultation is recommended before or shortly after beginning to try. Additionally, if you had irregular periods or other menstrual problems before starting birth control, it's a good idea to speak with a healthcare provider soon after stopping, as these issues may return and affect your ability to conceive. A doctor can help determine if any underlying health issues are affecting your fertility.
Conclusion
Ultimately, the time to become pregnant after stopping birth control is unique to each individual. For most methods, fertility returns swiftly, and waiting periods are not medically required before trying to conceive. The exception is the Depo-Provera shot, which can delay the return of fertility for many months. Open communication with your healthcare provider about your plans, along with healthy lifestyle choices, will provide the best foundation for a successful conception journey.
