Birth Control and Infertility

Key Takeaways

• Navigating birth control options can be complex, especially when considering your future fertility. Whether you're delaying parenthood, spacing pregnancies, or finding what suits your body best, it's a significant decision.
• Most birth control methods can be reversed, so your fertility usually goes back to normal once you stop using them. However, some methods might take a few extra months to return to your baseline fertility.
• For individuals who have opted for permanent birth control methods like tubal ligation or vasectomy, assisted reproductive technologies, including in vitro fertilization (IVF), can still provide an opportunity for pregnancy.
• It's essential to have an open discussion with your doctor about your needs and goals. He or she can help you weigh the pros and cons of different birth control methods and find the best fit for you.

Can Birth Control Affect Long-Term Fertility?

The good news is that most hormonal birth control methods and intrauterine devices (IUDs) do not affect your long-term fertility. They may temporarily prevent pregnancy, but your fertility typically returns to normal after you stop using them.

To cite one example, a 2018 study in Contraception and Reproductive Medicine found that contraceptives, regardless of type or duration of use, do not harm future fertility and do not significantly delay conception after discontinuation.

Various Methods of Birth Control

When thinking about birth control, many people immediately think of "the pill," but there are various options available. Each person is unique and may experience different side effects, so it can be helpful to try different types to find the best fit. Here’s a breakdown of the options:

Oral Contraceptive Pills

Oral contraceptive pills are the most commonly used reversible contraceptives. According to the Journal of American Medicine, they account for nearly 22% of all contraception in use.

Often referred to as "the pill," oral contraceptives come in two major types: combination pills and progestin-only pills (mini-pills):

• Combination Pills:

These pills contain both estrogen and progestin, preventing ovulation. Besides contraception, they can help with acne, PMS, heavy menstrual bleeding, and cramping. Some use them to regulate cycles or manage hormonal imbalances.

• Progestin-Only Pills (Mini-pills):These contain only progestin and work by thickening cervical mucus to keep sperm from reaching the egg. They are a good option for those who cannot take estrogen or are nursing.

Pregnancy rates for women using oral contraceptives range from 4% to 7% per year, with consistency being crucial. Side effects can include bloating, nausea, spotting, depression, and breast tenderness.

Vaginal Rings

The vaginal ring is a small, flexible device that is placed in the vagina for a month at a time. It releases hormones like estrogen and progestin to stop ovulation and make cervical mucus thicker. There are two primary types available: NuvaRing, which can be used for up to 5 weeks, and Annovera, which lasts for a year and can be used for 13 cycles.

Side effects are similar to oral contraceptives and can include nausea, headaches, sore breasts, and spotting. Some users may experience vaginal discharge initially.

Implants

The contraceptive implant, a matchstick-sized rod placed under the skin of the upper arm, releases progestin to prevent ovulation and thicken cervical mucus. It is effective for up to five years and can be removed when you're ready to conceive, with fertility returning quickly.

Common side effects can include spotting, particularly during the first 6 to 12 months, as well as lighter periods or even the absence of periods. Some individuals might also notice bruising or swelling at the site of insertion.

Intrauterine Devices (IUDs)

An IUD is a tiny, T-shaped device inserted into the uterus. There are hormonal IUDs (Mirena, Liletta, Kyleena, and Skyla) that release progestin to stop ovulation and thicken cervical mucus, and copper IUDs (Paragard) that create an unfavorable environment for sperm.

Hormonal IUDs can lead to lighter, shorter, or less painful periods, while copper IUDs may cause heavier periods. IUDs are effective for 3 to 10 years, depending on the type, and can be removed at any time to allow for pregnancy.

Insertion can be uncomfortable, and there is a small risk of the IUD being pushed out or piercing the uterine wall. Rarely, an IUD may cause scarring in the uterus, requiring surgical intervention.

Injections

The birth control shot, such as Depo-Provera, is administered every 3 months and is about 99% effective when used correctly. It provides longer-lasting protection than pills, but users must wait for the most recent injection to wear off before fertility returns, which can take up to six months.

Side effects may include changes in periods, acne, breast tenderness, headaches, mood changes, and weight gain.

Menstrual Irregularities Associated with Birth Control

Using birth control can lead to irregular periods due to changes in the body's natural ovulation cycle. Hormonal birth control can cause spotting, missed periods, or changes in period duration and flow, especially initially.Permanent Birth Control

Methods like oral contraceptive pills, vaginal rings, implants, IUDs, and injections are reversible. However, permanent birth control methods like tubal ligation or vasectomy may require assisted reproductive technologies like in vitro fertilization (IVF) for pregnancy.

When to Consult a Doctor

Discussing your specific needs and goals with your doctor can assist you in selecting the most suitable birth control method. Whether you're planning your family, thinking about birth control, or looking into fertility treatments, the board-certified specialists at Virginia Fertility & IVF are ready to support you throughout the process. Reach out to us for a personalized consultation to discuss your unique questions and concerns on your journey to parenthood.

This article is for informational purposes only and does not constitute medical advice. Please consult a fertility care expert for personalized recommendations.