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Birth control and infertility: Does using birth control hurt my chances of getting pregnant later?

News flash: Birth control = rubber, STIs = glue.

by Tina Raine-Bennett, MD, MPH

Women under 30 years old are incredibly fertile—their ability to get pregnant is at its peak. In the U.S., about three in four sexually active women under 30 are using some type of birth control. But many of them ask me, does using birth control now hurt my chances of getting pregnant in the future? Sigh of relief: it does not.

All reversible birth control methods will help prevent pregnancy while you’re using them, but none have long-lasting effects on your ability to get pregnant when you stop. That’s why women who use the Pill but accidentally forget to take it for a few days can get pregnant that month.

Let’s look, for example, at how long it takes for women to get pregnant when they quit the Pill compared to when they quit non-hormonal fertility awareness methods (FAM, sometimes called natural family planning). A big 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. Women who stopped using FAM had very similar rates of pregnancy, with 20-25% pregnant in one month and 80% pregnant in a year. In other words, women who quit the Pill get pregnant just as fast as other women, even if they’ve used the Pill for years.

Women who quit the patch, ring, or IUD get pregnant at similar rates. Contrary to popular myth, modern IUDs do not hurt your future fertility. For some women who stop using the implant or the shot (Depo-Provera), it can take a few extra months to start normal menstrual cycles again. There may be a delay of up to two months after stopping the implant and up to six months after stopping the shot, but this varies from person to person, and most women get pregnant soon after stopping these methods.

Okay, so birth control doesn’t hurt a woman’s chances of having a baby in the future. But there is something that does: untreated sexually transmitted infections (STIs). By the age of 25, one in two young people having sex will get an STI.

One of the most common STIs is a bacterial infection called Chlamydia. It’s transmitted by sexual contact, and can be prevented by using condoms. It’s easy to treat with antibiotics, but it’s sneaky: three in four women with Chlamydia don’t know they have it because they have no symptoms. Half of men with Chlamydia have no symptoms either. The longer a woman has an untreated STI like Chlamydia or Gonorrhea, the higher the chance that it will cause scarring in the tubes that connect her ovaries and uterus. That scarring makes it difficult for an egg to travel the right direction, and hurts her chances of getting pregnant in the future.

If you had sex with a new partner and didn’t use a condom, you can still protect yourself by getting tested. Luckily, getting tested for Chlamydia or Gonorrhea is easy and painless: you just pee in a cup. Getting treated just means taking some pills for a week. If you test positive, you can tell a partner he or she should get tested and treated using an anonymous e-card. And for future hookups, you can learn more about talking to a new partner about using condoms.

If you’ve never been tested, check out GYT—Get Yourself Tested, Get Yourself Talking. Lots of health centers around the country offer free or reduced cost testing. Find a place to get tested and keep infertility from sticking to you!

Tina Raine-Bennett, MD, MPH, is a Professor in the Department of Obstetrics & Gynecology at the University of California, San Francisco, and Medical Director of the New Generation Health Center. New Generation is a family planning and STD clinic for adolescents where Dr. Raine gets to do what she loves best: help young women.

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