Q: How soon can I get pregnant once I’ve taken out my IUD?
Answered by: Dr Ida Lilywaty Md Latar, Obstetrics And Gynaecology (O&G), Pantai Hospital Cheras (PHC)
An intrauterine contraceptive device or IUCD is a small device which is inserted inside the womb or the uterus and used as a contraceptive method. It has 2 types, the IUCD made from copper and an intrauterine system or IUS made from plastic that contains hormones in its shaft. Both types have two threads attached to its lower end and passed through the cervix or neck of the womb to lie in the vagina to ensure the ease of removal. The IUCD and IUS are classified as long-term contraception or the LARC. As the term implies, they are generally offered for those women who needs longer term contraception that need some time to be reversed.
The copper IUCD works mainly by making it difficult for sperm to fertilise an egg with the effect of the copper in the device that induces some degree of inflammatory process in the lining. It makes the mucus at the cervix and the lining of the uterus hostile to sperm and eggs preventing sperm travelling through the uterus. The IUS acts through localised hormonal effect that also leads to thickening of the mucus as well as preventing ovulation.
Most copper IUCDs work for at least three or five years and IUS generally used for five years. For those women over 40 years old when the device was fitted it can be assumed to last until they menopause. Modern-age IUCD is very effective with only 1-2 of every 100 women using the IUCD as contraception will become pregnant over five years of use. IUS has even been considered as one of the extremely effective contraception with very low failure rate making it one of the most reliable types of contraception available with an additional benefit as a treatment method for women with heavy menstrual bleeding.
“IUCD is very effective with only 1-2 of every 100 women using the IUCD as contraception will become pregnant over five years of use.”
Once the IUCD or IUS is in place it should work immediately. However, when it is fitted there is a very small chance that it may get expelled and if this is to happen, it usually will occur in the first 24-48 hours following insertion. Nevertheless, most women have no problems once it’s fitted and the IUCD/IUS can remain in place for several years to be removed as scheduled.
An IUCD can be removed at any time by a trained doctor or nurse. Fertility can potentially return immediately after IUCD or IUS removal and there is no waiting period for trying to conceive after removal although regular menstruation sometimes takes a few months to return after IUS removal as some of the local hormonal effect on the uterine lining may still persist.
Thus, for any woman who wants to have their IUCD or IUS removed but still wants to avoid pregnancy, she needs to use other methods of contraception like barrier methods or contraceptive pills for at least seven days prior to removal if reinsertion doesn’t happen immediately. This is because sperm can last up to seven days in the reproductive tract of a woman and can potentially fertilise an egg after the IUCD/IUS is removed.