Though It Rarely Ever Occurs People With Iuds Can Get Pregnant For A Few Reasons
The one thats really in your control: Keeping your IUD past its removal deadline.
You may be more likely to get pregnant if you dont remove your IUD per the manufacturer-approved timeline, Jessica Shepherd, M.D., a minimally-invasive gynecologist at Baylor University Medical Center at Dallas, tells SELF. How long is too long to keep your IUD past its deadline?
Whats interesting about this is that some research shows IUDs are actually effective past their manufacturer-approved expiration dates, but only in certain populations . For instance, a 2014 review in the journal Contraception found that Mirena was actually effective for up to seven years when its only recommended up to five, but these results were specifically in people who were at least 25 with children at the time of insertion. In that same demographic, Paragard was effective for up to 12 years . But, on the other hand, no evidence showed that Skyla was effective past its three-year deadline in any group of people.
Risks Of Becoming Pregnant With An Iud
Intrauterine devices small, flexible devices shaped like the letter T that are inserted into a womanâs uterus by a healthcare providerare one of the most effective reversible methods of birth control available. That said, around one of 100 women with an IUD get pregnant each year, with the highest risk occurring within the first year following the insertion.
While it is rare to become pregnant with an IUD, it does occur, and it is important to learn about the risks and complications associated with an IUD pregnancy.
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Can You Get Pregnant With An Iud In Place
hi there i am beginning to think that i might be in the same boat only had copper iud for just over a month. not had a period. should have had it last week. been very lightly spotting past few days, nausea breast tenderness bloating light headed. all what i had with my 2 kids, one 3 aother 15 weeks. relationship under strain hoping not to be. going to get a test later If a woman does not want to get pregnant after having an IUD removed, she should use another form of birth control. We found no difference in 12-month pregnancy rates or time to pregnancy between former IUD users and users of other contraceptive methods It is very unlikely you will get pregnant when using copper IUD. If you do get pregnant with a copper IUD, there is a higher chance of ectopic pregnancy. This means that the pregnancy may settle in the fallopian tubes . Reasons why the copper IUD might not be a good option for you: Heavy periods. Low iron levels I am now on birth control pills and will never get the iud again. anon152937 February 15, 2011 . I have had two Mirena IUD the first, for six months following a partial molar pregnancy, was inserted after the D& C was removed six months later when I was given the greenlight to get pregnant, some mild cramping at removal nothing serious
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What Is An Iud
An intrauterine device is a small contraceptive device that is put into the uterus to prevent pregnancy. The 2 types available in Australia are the copper IUD and the hormonal IUD . The copper IUD is designed to stay in place for up to 10 years and the hormonal IUD for 5 years. Both can easily be removed sooner, if needed.
Complications Following Mirena Insertion
Due to its effectiveness, many women choose this form of birth control. However, there can be complications, which may be serious. The most common side effects that Mirena warns users about are:
- Abdominal and pelvic pain
- Pelvic infections, and
- Ovarian cysts most are asymptomatic but can result in pelvic pain.
Bear in mind that in cases where pregnancy does occur, there is a risk of miscarriage or even infertility for patients that have used the Mirena IUD. In addition, there are more severe complications that can result, including:
- Device migration IUD moves out of place, requiring surgical removal
- Organ perforation
- Ectopic pregnancy fertilized egg implants outside of the uterus threatening the mothers life
- Neurological disorders, and
- Depression, anxiety, and mood swings.
Its important to seek medical help immediately if you have a Mirena IUD and experience any unusual side effects.
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What Is Mirena And How Does It Work
Mirena is a brand of T-shaped hormonal intrauterine device used for long-term birth control. This FDA-approved IUD is labeled to have an effectiveness of five years . It can only be placed by a healthcare provider.
Insertion of Mirena takes about five minutes and can be done during a regular visit to the doctor. The device is inserted using a few tools. It can be inserted at any time during the month, including the menses time, if you are not pregnant . If you are breastfeeding, your doctor will tell you about the right time to get it.
Mirena IUD works by releasing the hormone Levonorgestrel. This will thicken the mucus lining of the cervix to prevent the sperm from meeting or fertilizing the egg. It also thins the uterine lining, thereby, suppressing the ovulation partially. All of these will prevent pregnancy.
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But If You Got Your Mirena Or Paragard When You Were 25 Or Older You Might Want To Ask Your Doctor About Delaying Removal Or Replacement
Gynecologist Dr. Jen Gunter, MD, told INSIDER that she always informs her IUD-using patients about the extended use data, provided they fall into the right age range.
Gunter does acknowledge that the studies are small, but she also acknowledges that their results are pretty impressive: She cited one recent study that followed 398 women using Mirena 2 years past the expiration date. Those women reported zero pregnancies between years 5 and 7, she said.
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What Causes An Iud To Fail
Your IUD may not prevent pregnancy if it:
- Falls out. If the IUD falls out of your , you arenât protected against pregnancy anymore. Itâs important to check for the strings connected to the IUD to make sure itâs still inside you.
- Moves out of place. An IUD can also be in the wrong position. It wonât properly protect you if it isnât correctly fitted inside your uterus.
- Expires. IUDs have expiration dates. If you keep one in longer than the suggested amount of time, you have a slightly higher chance of pregnancy. You probably wonât have any side effects if you keep an IUD in after it expires, but we need more research to safely recommend this option.
- Hasnât started to work. A copper IUD, like Paragard, begins to work right after the doctor inserts it. But hormonal IUDs, like Mirena, donât start to work for 7 days. Use backup birth control, like condoms, for those 7 days to prevent pregnancy.
What Are The Hormonal Intrauterine Devices
The hormonal IUDs are small T- shaped plastic devices that are inserted into the uterus . The hormonal IUDs contain progestogen. This is a synthetic version of the hormone progesterone made naturally by the ovaries. The hormonal IUDs have a coating that controls the slow release of progestogen into the uterus. There are two different hormonal IUDs available in Australia. They are sold as Mirena and Kyleena.
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How We Handle Pregnancy With An Iud
Our first step is to determine the type of pregnancy, which could be either:
Intrauterine, which is the normal location for pregnancy development, allowing for fetal growth over 9 months, or
Ectopic, which is when a fertilized egg implants in a fallopian tube or other location outside the uterus and poses serious health risks to the woman
We used to believe that having an IUD increased the risk of having an ectopic pregnancy. Now we understand that because IUDs are so effective at preventing intrauterine pregnancies that, if a pregnancy does occur, theres a higher likelihood that it developed outside the uterus. But patients arent at increased risk for ectopic pregnancies just because they have an IUD.
Next, we look for the IUD strings in the cervix to potentially remove the device. Studies have shown that the risk of miscarriage, preterm birth, and infection of the amniotic sac and fluid before delivery is significantly higher when IUDs are left in place during pregnancy compared to pregnancies in which the IUD is removed. However, while taking out the IUD improves the pregnancy outcome, there is still a higher risk of pregnancy complications compared to patients who never had an IUD in place. For most women whose IUD strings are visible through the cervix, we recommend removal of the IUD at the first visit.
What Is A Miscarriage
A miscarriage happens if a pregnancy ends spontaneously before its 20th week. At that point, the fetus isnt developed enough to survive outside the uterus.
If you get pregnant while using an IUD, the device increases the risk of miscarriage. If you want to stay pregnant, its important to remove the IUD early in pregnancy.
Sometimes, an IUD can slip out of place. If that happens, the risk of pregnancy is higher.
To check the placement of your IUD:
Contact your doctor if:
- you cant feel the IUD string
- the IUD string feels longer or shorter than it used to
- you can feel the hard plastic of the IUD coming out of your cervix
Your doctor can use an ultrasound exam to check the internal positioning of your IUD. If it has slipped out of place, they can insert a new IUD.
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Here Are 5 Faq About Issues Related To Using Iuds:
1. What if the IUD moves?
It is uncommon for an IUD to move. If an IUD moves, it could result in some increased menstrual cramping or change in menstrual bleeding. There also is a small possibility that it could result in some discomfort during intercourse. If these symptoms occur, you should be evaluated by your health care provider.
2. What if the IUD comes out?
The risk of IUD expulsion is 36% for levonorgestrel IUD and 310% for copper IUD. If your IUD comes out, you should see your health care provider to discuss replacement versus changing to another form of contraception.
3. What if I do not have my period for a long time and then suddenly I have my period again?
Approximately half of women with a hormonal IUD will stop having their menstrual cycles. It is common for some women to have irregular, light menstruation with a hormonal IUD. If you have not had a menses for a prolonged period of time and then suddenly you resume your menses, you should see your health care provider.
4. What if I can’t find the IUD strings?
You should check your IUD strings regularly. It is common for IUD strings to get pulled up inside the uterine cavity, and this is the most common cause for not being able to feel the IUD strings. If you cannot feel the IUD strings after several attempts, you should be evaluated by your health care provider.
5. Can I remove the IUD by myself?
Okey Osuebi, M.B.B.S., is an OB-GYN in Fairmont, Minnesota.
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This Isn’t New Intel: Scientists Were Studying Extended Use Of Copper And Hormonal Iuds Back In 1990s
So why haven’t you heard about it yet?
For one, the makers of IUDs aren’t exactly publicizing these findings. They don’t have much incentive to get women to use their products less frequently.
But there’s also a big, important caveat: Studies of extended IUD use have only been done in women who were age 25 or older and had at least one child when they got the device inserted.
These findings could also apply to women who haven’t had kids we just don’t yet have the data to know for sure. And since younger women have higher odds of getting pregnant, they may not be able to use IUDs past their approved expiration dates, either.
Plus, the studies while high in quality have looked at a relatively small number of women. So it makes sense that some experts are wary of pushing the IUD’s lifespan.
“The data is limited but promising,” Dr. Salena Zanotti, MD, a gynecologist at the Cleveland Clinic, told INSIDER. “To ensure adequate contraception, we do recommend following the labeling until larger studies have been done.”
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Infertility Is Caused By Scarring
Infertility is not caused by the IUD or the removal process. Instead, infertility is caused by disease or infections of the organs and tissues in your pelvic region and the scarring that if often leaves behind. Absent those conditions, your ability to get pregnant after using an IUD is the same as it was before your IUD.
Notwithstanding your immediate fertility, some doctors recommend their patients wait for a cycle or two after IUD removal before trying to conceive. By waiting, it is easier to track your cycle and determine the exact date of conception.
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Still Using An Iud Past Its Approved Expiration Date Is Considered Using It Off
That’s a catchall term to denote when doctors prescribe meds for a different use than originally intended.
“We use things off label very commonly in medicine, and I explain that to people,” Gunter said. “And some people are totally comfortable with that.”
But some people aren’t and that’s okay.
“If you have somebody who is incredibly anxious and simply cannot accept the fact that we don’t have large studies with thousands of women designed specifically to look at this question, then they might want to have their IUD replaced ,” Gunter said.
But for others, extended use could be a huge boon. Take women whose IUDs aren’t covered by insurance, for example. “The average cost of a Mirena is $700,” Gunter said. “If you extend the lifespan for two more years, you’re going to $100 a year rather than $140 a year. For some individual people, that’s going to make a difference.”
And if you found IUD insertion to be painful or uncomfortable, replacing the device less frequently is a pretty attractive concept.
The bottom line: If know you want to replace your IUD exactly at the FDA-approved time, go for it. But if you had your ParaGard or Mirena inserted at age 25 or older, and you’re okay with using the device off-label, it’s worth talking with your doctor about extended use.
“I would let the patient make the choice,” Gunter said. “People should make a decision that’s best for them in a consultation with personal doctor.”
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Desire To Continue The Pregnancy
If the woman wishes to continue with the pregnancy, a doctor will perform a pelvic examination. If the IUD strings are visible, the doctor will remove the IUD gently.
If the IUD strings are not visible, a woman may need to undergo an ultrasound to determine its location. The next course of action depends on the location, as below:
- No IUD found: The woman will need an X-ray to locate the device.
- IUD within the cervix: The doctor will remove the IUD by pulling the strings.
- IUD above the cervix: The doctor will talk about the risks and complications of continuing the pregnancy.
How Soon Can You Get Pregnant
This is a different question just because your fertility has returned doesnt mean pregnancy will happen right away.
This can be a really odd experience for someone who has spent years preventing pregnancy. You might assume that without birth control, you would have conceived immediatelybut thats not entirely accurate.
Once you stop contraceptives, you may conceive the very first fertile month, or you may need to try for up to a year. This is the same as for those who have not used any birth control.
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What Happens To Your Body If You Leave An Iud In For Longer Than Expected
“After , the main concern is an unwanted pregnancy, but some women keep it in because of the lighter flow during a period,” Schkodzik added.
Some people may have lost insurance coverage and the procedure to remove an IUD can be expensive. Laubscher, who does not live in the United States, said she had to get her previous IUD removed “in theater,” which is the equivalent of an operating room, as it could not be removed locally. It’s important to note that if cost is the barrier to removing your IUD, it can usually be performed by Planned Parenthood, a school clinic or a women’s health center for free, or at a low cost.
“I have never had any discomfort, unplanned pregnancy or health issues because of the IUD,” Laubscher said. “That might be one of the reasons that I haven’t taken it out yet. Other than that, I might use the pandemic as an excuse, but it really is not.”
After it serves its purpose, it will be an inert foreign object and our bodies will treat it as such and start to defend from it in forms of embedding, infection or perforation.
Unplanned pregnancy is not the only risk associated with leaving IUDs in past their expiration date. Schkodzik explained negative side effects may include the IUD becoming embedded in the uterine wall, in which case a medical professional would need to take it out.
“This can be very painful,” she said. “There is also a chance of an infection caused by bacterial biofilm on the device.”
