Can birth control now impact pregnancy later?

Dr. Judith Reichman TODAY contributor • Profile • E-mail

Q: If I stay on the Pill until I conceive will it take longer to get pregnant?

A: Most probably not. A European study on oral contraceptives called the EURAS-OC study (European Active Surveillance Study on Oral Contraceptives) prospectively followed more than 2,000 women on the Pill who stopped taking it to try to conceive. The women were followed for at least two years after stopping oral contraceptives to examine how long it took them to get pregnant.

The study found that within just one cycle of stopping the Pill over 21 percent of the women had become pregnant. This was virtually identical to the natural pregnancy rates of 20 to 25 percent per cycle in women who are not using any form of birth control. One year after they discontinued oral contraceptives 79.4 percent of the women were pregnant. The median time to conception was three months. These numbers are pretty much the same as for non-birth-control-pill users. In other words, prior use of the Pill seemed to make no difference to future conception.

The study also looked at women who used the Pill for more than 24 months (long-term use) and found that it also had no effect on conception rates. Of the women who took the Pill for 24 months or less, 79.3 percent become pregnant after a year of stopping its use, versus 81 percent of women who had been on birth control for more than two years.

Long-term use of the Pill, however, does lower the future risk of ovarian and endometrial cancer and perhaps decreases the chances of developing endometriosis, cysts and even pelvic inflammatory disease (PID). Not to mention the fact that oral contraception can decrease cramps and heavy bleeding, and provides very effective contraception when you need it (if you take it according to the instructions).

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“When you go off the Pill it takes longer to get pregnant” is an old wives' tale (or maybe we should call it old man's tale, since I'm not sure where that saying comes from)!  It applies ONLY to women with underlying ovulation problems. Without the Pill these women might have irregular cycles; the Pill corrects the problem of bleeding too often or too rarely, but does not stimulate the ovaries or make then behave. (Au contraire, the Pill does a corporate takeover of ovarian action and suppresses ovulation; hence it provides birth control). So if you had underlying ovulation problems (and irregular cycles) that were treated with the Pill, stopping this therapy could unmask that original problem; it may then take longer to conceive and fertility medications might be necessary to get the ovary to produce viable eggs in a timely fashion.

Finally, multiple studies have shown that getting pregnant immediately after going off the Pill does not increase the risk of a miscarriage. Remember, the Pill is out of your system within a few days of stopping it (that’s why you get your period at the end of a cycle when you finish the active pills or can have breakthrough ovulation, and an undesired pregnancy, if you miss pills).

Dr. Reichman’s Bottom Line: If you want to take the Pill, go for it. When you're ready to get pregnant, just stop and try to conceive — don’t expect your fertility to be delayed or “damaged.”

Dr. Judith Reichman, the TODAY show's medical contributor on women's health, has practiced obstetrics and gynecology for more than 20 years. You will find many answers to your questions in her latest book, "Slow Your Clock Down: The Complete Guide to a Healthy, Younger You," which is now available in paperback. It is published by William Morrow, a division of HarperCollins.

PLEASE NOTE: The information in this column should not be construed as providing specific medical advice, but rather to offer readers information to better understand their lives and health. It is not intended to provide an alternative to professional treatment or to replace the services of a physician.

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