It often feels like women spend most of their lives trying not to get pregnant. So, once you’re ready to start trying for a baby, it can be confusing to know how to get off birth control pills and how long it might take you to conceive. Will it take longer? Could you get pregnant right away?
That’s why we went straight to a gynecologist to explain how to go off your birth control pills if you want to conceive. First, you should understand how birth control works and what kind of pill you take.
“Combined oral contraceptive pills — which usually contain estradiol and a progesterone derivative — work primarily by preventing ovulation,” says Rachel Urrutia, MD, MSCR, assistant professor in the Department of Obstetrics and Gynecology at the University of North Carolina at Chapel Hill. “When women do not ovulate, they cannot conceive.”
You could also be taking a progestin pill. “Progestin-only pills contain a progesterone derivative,” Urrutia explains. That means pregnancy prevention can vary depending on the dose of the pill, individual factors related to the woman, and in the same woman, different factors in different cycles. “These include inhibiting ovulation, thickening cervical mucus which may prevent sperm transport, slowing tubal motility which may prevent the egg and sperm from meeting, and altering the endometrial lining which may inhibit implantation of an embryo.”
The good news is that regardless of the type of pill you’re on, it won’t take your body long after stopping either pill for your cycle to return to normal. “Fertility usually resumes within several months of discontinuing oral contraceptives,” Urrutia says. “I usually recommend allowing three to four months for the cycles to return to a normal pattern and for the hormones to be completely out of the body.”
But, you could get pregnant right away, ladies. “It is important to note, however, that fertility can return immediately after stopping and I have definitely taken care of people who have conceived without ever getting a first period after stopping their oral contraceptives,” Urrutia says.
While it’s tough to nail down a timeline, in general, it can take up to a year for your body to get back onto a normal cycle. “The overall fertility of people who have stopped oral contraceptive pills seems to be lower temporarily, but one year pregnancy rates of pill users have been found to be 72 to 94%, which is comparable to that of users of other methods,” says Urrutia.
Rest assured that if you’ve been on birth control for a long time, it shouldn’t impact your ability to get pregnant. “There is no indication that longer term use of pills affects fertility,” says Urrutia.
Another fact you should know is if you do conceive quickly after going off birth control, it should not impact the health of your pregnancy. “Conceiving quickly after oral contraceptive use has not been associated with a higher rate of pregnancy complications, including miscarriage,” says Dr. Urrutia.
But if you’re concerned about your cycle or want to try to start trying to conceive right away, Urrutia suggests tracking your fertility after going off the pill to make sure your body is getting back to normal. “This will help women confirm that they are seeing a normal pattern of ovulation and a normal luteal phase prior to trying to conceive,” she explains.
Of course, if you are worried about your fertility after going off birth control, or are looking to go off birth control to start conceiving, consult your gynecologist.
A version of this story was published April 2019.
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