Considering that you’ve spent years trying to ensure that you didn’t get pregnant, it’s natural to be a little concerned regarding your chances of conception when it’s time to start a family, and you may be apprehensive of the result of using birth control for years. There are a lot of half-baked truths floating around – you may receive contradictory answers to how contraceptives like the IUD, the pill, and Depo-Provera influence fertility. But the writing on the wall reveals that right after you stop birth control methods, your fertility will return to the state it was in before, as if you were never on birth control. However, there are a few exceptions.
Can Birth Control Cause Infertility?
Research shows that birth control does not cause infertility. However, some myths around birth control causing infertility do exist. Some women can experience certain postponement in restarting ovulation and periods following continued birth control use. It can take a few months for the menses to resume after discontinuing birth control. When a woman is using the pill for some time, the added hormones can cover ovulatory issues while affectedly providing her menstrual cycle. Alterations in the body owing to increased weight or stress which can impact a woman’s menstrual cycle often get masked by pill use.
Furthermore, the level of fertility usually depends on several factors which may not be related to using birth control. For instance, you are not the same age you were when you started the birth control pill – if you were 20 then and are 30 now, the likelihood of getting pregnant may have reduced owing to your age.
It is true that many hormonal contraceptive methods can have risks. However, infertility may not feature as one of them. Several studies suggest that your chances of conception after stopping birth control are as high or low as that of a woman who never used any. There can be a small wait period between the time you discontinue birth control and the return of fertility, which is generally short.
Having said that, new evidence in the form of smaller studies has emerged that raise alarms regarding longstanding risks to contraceptives for some women. However, you may want to take this research with a pinch of salt.
1. Hormonal Birth Control
Some of the common hormonal birth control methods include:
- Birth Control Pills
The oral contraceptives depend on hormones oestrogen and progesterone (some have both, while others contain only progesterone) to stop pregnancy.
- How Does it Affect Fertility
The pill is a popular method of birth control. Research indicates that both short-term as well as long-term users of the pill can experience a brief delay in fertility as compared to users who discontinue barrier contraceptives like diaphragms or condoms. But after the temporary wait spell, the monthly fertility odds are similar to those of females ending other means of birth control. About 20 per cent users achieved pregnancy in their initial cycle after stopping the pill, and 80 per cent within a year or so.
Interestingly, research reveals that the long-term use of the pill can enhance the possibility of pregnancy. Women who used the pill for about five to six years were found to be more fertile as compared to those who used them for merely two years. But there is a contrasting theory which states that hormonal contraceptive like the pill can mess up fertility when used for a very long time (10 years or more). Such an extended use can thin a woman’s endometrium lining of the uterus which may impact implantation. In other words, she can conceive but may not be able to maintain the pregnancy.
- IUD
Intrauterine Device or IUD is a tiny piece of T-shaped plastic. It releases a small quantity of hormone progestin into the body which is very much like the hormone progesterone that a woman’s body naturally produces. Progestin blocks the sperm cells from reaching the eggs by thickening the mucus on the cervix. Also, it prevents eggs from leaving the ovaries thus deterring pregnancy.
- How Does it Affect Fertility
Studies reveal that non-IUD users and IUD users have comparable pregnancy rates. In most cases, normal fertility is re-established within a few months after removal of IUD with maximum women conceiving in a year. The International Journal Of Women’s Health arrived at a parallel conclusion in 2009. Its report stated the contraceptive effects of IUD reversed soon after elimination of the device.
- Vaginal Ring
The vaginal ring (NuvaRing) is a transparent, soft ring implanted into the vagina which delivers a measured release of hormones progesterone and oestrogen in the body for about three weeks. It stops the release of eggs every month, thickens cervical mucus, thins the womb lining to prevent pregnancy.
- How Does it Affect Fertility
Not much is known about the influence of NuvaRing on fertility. The few studies conducted in this regard point to a woman’s capability to instantly ovulate though not necessarily conceive after doing away with the NuvaRing. The most investigation is based on statistics obtained from studies done a long time back.
2. Non-Hormonal Birth Control
Following are the hormone-free means of birth control:
- Tubal Ligation
Tubectomy or tubal ligation is a surgical procedure wherein the fallopian tubes of a woman are sealed, cut or clipped which hinders eggs from travelling to the uterus for embedding. It is a one-time, permanent method of birth control. Another technique of prohibiting conception is tubal implant which involves insertion of a tiny, spring-like coil into the fallopian tubes to block them.
- How Does it Affect Fertility
Both the methods are irreversible, which means a woman is not likely to conceive again.
- Fertility Awareness Methods
Such methods comprise natural techniques of birth control such as tracking the menstrual cycle, taking the body temperature, observing the cervical mucus to predict ovulation. A couple may abstain from having intercourse on days when a woman is most fertile or ovulating.
- How Does it Affect Fertility
Fertility awareness methods do not encompass medical interventions or variables like a foreign object or added hormones. They solely rely on natural practices. Therefore it is highly unlikely that they bear any risk to fertility.
- Copper IUD
The copper IUD or ParaGard is a T-shaped device formed of copper and plastic inserted into the uterus. It releases copper ions that are toxic for the sperm prohibiting them from reaching the eggs.
- How Does it Affect Fertility
Copper IUD can be removed any time, thus giving you a quicker return to normal fertility. Studies disclose copper IUD users who discontinue its use as they desired pregnancy and non-IUD users, both displayed comparable pregnancy rates. Also, there was no noticeable variation in the total time taken by women from both the groups to get pregnant.
- Barrier Methods
Barrier methods include the use of diaphragms, sponges,cervical caps, condoms which physically stop the sperm from fertilising with the egg.
- How Does it Affect Fertility
In the case of barrier methods, you can regain your fertility the moment you don’t use them. They work merely for the time they are in the body. Condoms can help the cause of fertility by protecting a couple against STDs (Sexually Transmitted Diseases) like gonorrhoea, chlamydia which may cause infertility. Although your doctor may advise you to go in for a complete check-up like basic blood tests, start vitamin supplements, discuss lifestyle changes like lose weight, quit smoking if required to increase the odds of conception.
- Spermicide
People generally use spermicide along with one of the barrier methods to intensify the effectiveness against pregnancy. Spermicide contains Nonoxynol-9, a chemical that not only blocks sperm but also slows or kills them before they can reach the egg. It commonly comes as a foam, cream or gel.
- How Does it Affect Fertility
Nonoxynol-9 can erode the cell membranes which can enhance the risk of sexually transmitted infections and genital lesions. It can also cause changes in the vaginal bacterial flora which may result in the occurrence of vaginosis or other microbiome imbalances. It can have an adverse effect on sperm health as well as irreversible and permanent damage thereby affecting fertility. But doctors continue to be confused about this issue. It is yet to be established by substantial medical research. However, medical professionals do agree on the potentially harmful effect of lubricants on sperm health which can jeopardise a couple’s fertility.
Every woman’s body is different. It may respond differently to birth control and can work diversely to regain health after birth control to become pregnant naturally. The truth of the matter remains that several mechanisms in medicine still need to be explored to identify how exactly birth control can impact a woman’s fertility. A lot of dedicated and detailed research is required to recognise the full scope and degree by which different means of birth control are likely to affect fertility.
