Stopping contraception

When you decide to try for a baby the first and most obvious thing to do is stop using contraception, what may come as a surprise however, is that the type of contraception you have been using may impact how long it takes you to fall pregnant.

The Pill

The pill is one of the most popular forms of birth control in this country. There are two types of pill. The progesterone only (mini pill) and the combined pill. Many women will be on the combined pill but if you are breastfeeding, over 35 or a smoker (or for other reasons seen by you doctor) you may be advised to take the progesteone only pill instead. These pills work by surpressing ovulation and causing the mucus of your cervix to thicken making it difficult for sperm to reach the egg. Both pills are very effective when taken correctly (around 99%) and in most cases have no long term effects of fertility. In fact, most women return to full fertility within weeks of stopping the pill and can become pregnant in their first non - pill cycle. However, for some, cycles may be irregular in the first months off birth control, stabilizing only after a number of cycles have passed, the number of women still waiting for their first period after six months off the pill is less than 1%.*

The first step in assesing whether or not you fertility has returned is to find out if you are ovulating. *please note: even with irregular cycles it is still possible that you are ovulating and therfore you can still get pregnant even if your cycles do not return to normal straight away*.There are a few ways of doing this the two easiest being fertility charting or using ovulation tests. I would personally reccomend fertility charting as using ovulation tests could get expensive until you know roughly when you are likley to ovulate. See the "fertility charting" article for more information on how to go about charting you fertility signs. If you have not yet stopped taking the pill it is a good idea to start charting temperatures as soon as you take your last pill as it only works if you start in the first half of a cycle, not if you start after ovulation has already occured.

If you are reading this wondering whether you have become pregnant while still taking the pill the answer probably lies with your usage of the pill. With perfect use the combined pill has a failure rate of roughly 0.2 - 0.3% BUT if you take the pill outside of the safe window (normally 12 hours) or if you miss pills then this failure rate is higher. Some medications can affect the pill but most common ones do not (if you are worried ask your doctor when they prescribe it). Symtpoms of pregnancy on the pill are generally the same as a non pill pregnancy with the main symptom being no bleeding when you expect it. A pregnancy test will not be affected by the pill although it may be a little more difficult to know when to take it.

The Patch

The patch works in the same way as the pill, by preventing ovulation. Although  the patch only need be changed once a week rather than taken once a day like the pill. Its effects on long term fertilty are much the same as the pill in that you should not expect to see any reduction in long term fertility when you stop using the patch. Although, as with the pill it is possible it may take a few months for your cycles to stabilize. *please note: even with irregular cycles it is still possible that you are ovulating and therfore you can still get pregnant even if your cycles do not return to normal straight away*.

Contraceptive Injection

The contraceptive injection works by stopping ovulation, making cervical mucus thicker (less " sperm friendly") and thinning the lining of the uterus to prevent implantation. The main kinds of contraceptive injectiob used in the UK are depo - provera and Noristerat, the former giving 12 weeks protection from pregnancy the later giving 8 weeks protection. Its nature means that it remains in your system for at least 2-3 months and so if you decide shortly after having the injection that you are going to try and conceive you will need to wait at least that long. As well as this there is a more frequent occurance of delayed return to fertility with the injection than with the pill. However in the long term there is very unlikely to be any significant effect on your ability to get pregnant.

The Contraceptive Implant

The contraceptive implant in a small tube which in placed under the skin. In the UK this is normally called Implanon, it slowly releases hormones into your blood stream which prevent ovulation and therefore pregnancy. When the implant is removed your periods will normally return to normal within a month or so. Its in unlikely to affect your ability to get pregnant soom after use.

Barrier Methods

Barrier methods such as condoms or diaphragm loose their effectivness the first time you have sex without using them therfore it is possible to get pregnant extremely quickly after you decide to stop using contraception.

Intrauterine Methods

Intrauterine methods such as IUD work by preventing feritilization. If you have it removed closely following ovulation it is possible to become pregnant from unproctected sex soon before it was removed. Although most women who have an IUD removed will have full fertility return it CAN negativly effect fertility if any infection or damage to the uterus and tubes occurs. In extreme cases infection can lead to a hysterectomy although this is very rare. Additionaly with some types of intrauterine device (which also release hormones) can take a while to get out of your system.

Sources:

* http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2209874&dopt=Abstract