Birth Control & Fertility


For a lot of women, by the time they are ready to start trying for a baby, they might have already spent a number of years trying to prevent the very same thing. The common worry is how soon they will be able to revert to normal fertility, or even if at all. I have spoken with a lot of women who blame their immediate past birth control plan on their delayed conception. Whilst there are a lot of contradictory opinions out there, the truth is that, if all other conditions are favourable (i.e. functional tubes, uterus, and hormonal function), fertility should eventually be restored. However, this depends on the type, and duration, of birth control deployed.


1. Condoms

If this was your birth control mode, you throw any concerns you might have into the dustbin. The speed with which you return to fertility is literally the minute you decide not to use it. In fact, this is such a non-issue that I think we shouldn’t waste any time on it, and instead move on to the next birth control method.


2. Birth Control Pills

Even the length of time varies from woman to woman, it is expected that 80% of women will conceive within a year of going off the Pill. Some could conceive as quickly as the very cycle they stop taking it, whilst for some it might take a few more cycles. But (and like I stated earlier, barring any other circumstances), it is expected that a woman will return to her pre-contraceptive state. This is why a lot of women will fall pregnant if they do not take their pills properly, because they do not generally inhibit fertility for an extended length of time.

To further buttress this point, a recent study of over 2,000 women who quit the Pill after using it for an average of seven years found that 21% were pregnant in one month and 79% were pregnant in a year. On the other hand, women who were on more natural modes of family planning, such as timed sex, or even the condom, had very similar rates of pregnancy, with 20-25% pregnant in one month and 80% pregnant in a year. Basically, women who quit the Pill get pregnant just as fast as other women, even if they’ve used the Pill for years.


3. Hormonal Contraceptives

With this mode of contraception, the return to fertility is not as quick. Depo-Provera, one of the most common of these contraceptives (usually injected into a woman’€™s buttocks, or arm, once every three months to prevent ovulation), is not meant for women who want to be pregnant any time soon. Before prescribing this drug, doctors must confirm what a woman’s reproductive timeline is. This is because Depo-Provera can have lingering effects on fertility. Even though it stops working reliably as birth control after three months, because it is administered in the muscle, it persists in your body for many months longer.

On the average, fertility is restored about 10 months after the last shot, even though pregnancy can occur as quickly as three months after. About 18 months after the last shot, the rate of pregnancy for former Depo users is the same as any other woman’s.


4. IUD

About 20 to 30 years ago, IUDs were at their least popular, as they were blamed for a high incidence of PID (Pelvic Inflammatory Disease). The IUDs of that time were to blame for a lot of delayed conception cases, considering the negative effect PID could have on the tubes especially.

However, improvements have been made to this contraception mode, and now the risk of PID is extremely low, with only a slightly increased risk in the first few weeks after insertion.

When the IUD is removed, return to fertility is quite rapid, hovering between the expected time for former users of the Pill and the expected time for former Depo-Provera users. As the ovary is not directly affected by the device, the uterus is able to recover after about a cycle, with fertility returning to its expected condition.


5. Sterilization

I sometimes wonder why people opt for something as permanent as this. Yes, you might be convinced that you absolutely do not want any more children, but I have heard of so many instances whereby people seek to reverse this. Sometimes after a divorce, separation, bereavement, or just for the sake of being broody, between 1 and 5 percent will eventually change their minds and ask for a reversal of the procedure. I can’t count how many women were on the online forum I belonged to a few years ago, who were TTC after a reversed tubal ligation or vasectomy.

The reversal success rate is higher with men than women. Between 85 and 97 percent of men will eventually have sperm in their ejaculate, and about 50 percent of these couples will go on to achieve pregnancy. The most significant factor is the length of time between the vasectomy and the reversal. On the average, it should take about 12 months.

For women, it is a different story. After a tubal ligation reversal, chances of getting pregnant could be anything from 40 percent to about 70 percent, depending on age, length of time between the ligation and the reversal, the method of the original surgery, and the length of tube left to be joined. However, fertility levels will never go back to what they once were. Once the tubes have been damaged, there will always be some scarring when they are put back together. There is also a greater risk of ectopic pregnancy after a reversal.

So, you need to think long and hard before opting for this contraceptive mode. If there is even the tiniest chance you might want to conceive again, don’t even consider it!!!

The morale of the story is that, for the most part, after 12 months fertility is supposed to balance out and be the same as the person who was never on any form of contraception. However, there are still some discussions about the lasting impact of contraceptives on hormones, especially progesterone, but these have not been substantiated. I am particularly interested in finding out how this research will unfold, as it could completely destroy the theory of birth control not affecting fertility. But until it is confirmed, we will accept the fact that there are no long lasting effects.

That said, one has to be prepared for the accompanying side effects of these contraceptives, including extreme weight fluctuations (I know someone who went from a UK size 10 to 22, thanks to Depo), bloating, raised blood pressure, mood swings, hair loss, increased incidence of some cancers (breast, cervical, and liver), etc. That said, they also protect from some types of cancers, such as endometrial and ovarian.

Good luck….and baby dust to all!!!


Join the conversation with any of our TTC and Pregnancy Groups here

Photo Credits




  1. I am still so angry with myself for trying to prevent pregnancy!! I went from iud(stopped because I read about ectopic pregnancy) to the injection(it was making me bigger) then the pill(my boyfriend now DH asked me to stop using it just so my body can get ready) within a period of 5 years. Personally, I don’t even advice anyone to be on any apart from condoms as I don’t even know which one out of the three is causing my delayed conception.


Please enter your comment!
Please enter your name here