Does Birth Control Cause Infertility?

Key Takeaways

• Figuring out birth control can feel complicated when you're also thinking about your fertility journey.  It’s a decision that deserves careful consideration, whether you're putting off parenthood for now, spacing out pregnancies, or just figuring out what works best for your body.
• Many forms of birth control are reversible, meaning that once you stop taking them, your fertility will usually return to normal. Some birth control methods can take several months longer to get back to baseline fertility.  
• If you’ve undergone permanent birth control, such as a tubal ligation or vasectomy, there are still potential options for achieving pregnancy through assisted reproductive technology treatments like In Vitro Fertilization (IVF). 
• We recommend having an honest conversation with your doctor about your individual needs and goals. Your doctor can also help you evaluate the pros and cons of different birth control methods and determine the best options for you.

Can Birth Control Make You Infertile in the Long Run?

Good news: Most hormonal birth control methods and IUDs do not affect your future fertility. While they temporarily delay fertility and prevent pregnancy, your fertility levels will typically return to normal when you stop using birth control. A 2018 study by Contraception and Reproductive Medicine found that using contraceptives, regardless of how long or what type, does not harm the ability to conceive after they’re stopped – and they don’t significantly delay chances of getting pregnant either.

Different Methods of Birth Control

While many people automatically think of “the pill” when they think of birth control, there are actually various options for individuals seeking long-term contraceptives. Each person is unique and can experience a range of side effects, so it can be helpful to try different types of birth control to determine the best fit. Let’s break down the different birth control options below.

Oral Contraceptive Pills

According to the Journal of American Medicine, oral contraceptive pills are the most commonly used reversible contraceptives. They account for nearly 22% of all contraception in current use. Often called “the pill,” oral contraceptives come in two main types: combination pills and progestin-only pills (or mini-pills).

Combination Pills

These pills contain a mix of two hormones: estrogen and progestin. They work by preventing ovulation, or the release of eggs from the ovaries. Besides contraception, combination pills can help with acne, premenstrual syndrome (PMS), heavy menstrual bleeding, and cramping. Some people even use combination pills to regulate their cycles or manage hormonal imbalances.

Progestin-Only Pills (Mini-pills)

Like the name suggests, these pills contain just one hormone – progestin. They work by making it harder for sperm to reach the egg, thickening the cervical mucus consistency. Mini-pills are considered a good option for those who can’t take estrogen or are nursing. 

Pregnancy rates of women using oral contraceptives are reported to be between 4% to 7% per year (consistency is key!) Side effects can include bloating, nausea, spotting, depression, and breast tenderness.

While some may experience minimal discomfort, others may find certain formulations more challenging to tolerate. It's important to discuss your individual needs and concerns with your healthcare provider to find the most suitable birth control option for you. 

Vaginal Rings

The vaginal ring, also known as the birth control ring, is a small, flexible ring that you insert into your vagina once a month. It works by releasing estrogen and progestin hormones into your body, mimicking your natural hormones to stop ovulation and thicken cervical mucus to prevent pregnancy (similar to combination pills).

There are two main types of birth control rings: NuvaRing and Annovera. NuvaRing lasts up to 5 weeks, while Annovera is a year-long option with 13 cycles.

The potential negative side effects of vaginal rings are similar to those of oral contraceptive pills and can include nausea, headaches, sore breasts, and spotting between periods. Some users also experience a vaginal discharge during the first several months. 

Implants

The contraceptive implant is a matchstick-sized, flexible plastic rod that nestles comfortably under your skin, in the upper arm. The implant releases a steady dose of the hormone progestin, so it puts a pause on ovulation while also thickening the cervical mucus. This creates a slippery environment that makes it tough for sperm to reach their destination.The implant can be a good option for those needing long-term birth control.

It's effective for up to five years, and it's easy for your healthcare provider to remove when you're ready to start trying for a family.  Once it's out, patients can get back to their regular fertility fairly quickly. The most common side effect patients experience with the implant is spotting, especially within the first 6-12 months. However, most users enjoy lighter periods or no periods. Some experience bruising or swelling where the implant is inserted, although these side effects rarely last longer than a few days.

Intrauterine Devices

An intrauterine device (IUD) is a small, plastic T-shaped contraceptive that your healthcare provider inserts into your uterus. It comes in two different types: hormonal and copper. Both serve to stop sperm from reaching and fertilizing an egg.

Hormonal IUDs (Mirena, Liletta, Kyleena, and Skyla)

These IUDs release the hormone progestin to suppress ovulation and make cervical mucus thicker to block sperm. They’re effective, low-maintenance, and reversible. Hormonal IUD users generally experience lighter, shorter, or less painful periods, while others may stop having periods altogether after several years.

Copper IUDs (Paragard)

Instead of using hormones, this IUD releases copper, which creates an unfavorable environment for sperm. Non-hormonal IUD users may experience heavier periods.

Just like any birth control method, there are pros and cons to weigh. An IUD has proven effective for the longer-term – anywhere from 3 to 10 years depending on the type – and your doctor can remove it at any time to allow you to become pregnant with little to no delay. In addition, it’s highly effective with less than a 1% chance of pregnancy.However, the process of inserting an IUD can feel temporarily uncomfortable or even painful for some people.

There’s also a small risk that the IUD could get pushed out from the uterus. If this happens, it may no longer provide effective contraception. On rare occasions, the IUD can pierce through the uterine wall during insertion, a serious but uncommon complication. Also on rare occasions, an IUD may lead to scarring in the uterus following removal, which could require future surgical intervention to correct the defect. 

Injections

The birth control shot, also known as Depo-Provera or DMPA as a common brand, is a hormone injection administered once every 3 months to prevent pregnancy. Your healthcare provider administers the shot in your arm or rear end, and it’s about 99% effective when used as directed. However, it becomes less effective when users get off schedule with their shots.Unlike pills, the birth control shot provides longer-lasting protection.

If you decide to become pregnant, you simply stop getting the shot – although users must wait for the most recent injection to run its course. This can mean a wait of up to six months before normal fertility returns.Regarding side effects, birth control injections may cause changes in your period, including unpredictable bleeding. Other side effects can include acne, breast tenderness, headaches, or mood changes. It may also affect your appetite or cause weight gain, especially for those who struggle with being overweight.

Menstrual Irregularities Associated with Birth Control

When using birth control, it’s common to experience irregular periods since the body’s natural ovulation cycle is usually affected.

With hormonal birth control, users can experience side effects such as spotting or bleeding between periods, missed periods or periods that are heavier or lighter, or have a longer or shorter duration. These side effects are especially common at first, while the body is adjusting to the new changes. Permanent Birth Control

The birth control methods outlined above – oral contraceptive pills, vaginal rings, implants, IUDs, and injections – are all reversible birth control methods. This means that they can be stopped relatively easily, and users can resume trying to conceive. However, if you’ve gone through a form of permanent birth control such as a tubal ligation or vasectomy, certain assisted reproductive technology treatments like in vitro fertilization (IVF) may be needed to present a viable path forward for pregnancy. 

When to Consult a Doctor

Having an open conversation with your doctor about your individual needs and goals can help you weigh the pros and cons of different birth control methods and determine the best options for you.

Whether you're starting your family planning journey, thinking about birth control, or ready to explore fertility treatment options, our board certified fertility care experts at SDFC are here to help you every step of the way. Contact us for a personalized consult appointment, and together we can address your unique questions or concerns on your path to parenthood.  

This article is for informational purposes only and is not intended to represent medical advice. Please consult with a fertility care expert for personalized recommendations.