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Time to Ovulation After Removal of NEXPLANON® (etonogestrel implant) 68 mg
Return to ovulation was observed to occur as early as 7 to 14 days after removal of NEXPLANON® (etonogestrel implant) 68 mg. Review the clinical trial data for NEXPLANON.Clinical Data
Return to ovulation
In clinical trials, pregnancies were observed to occur as early as 7 to 14 days after removal.
In clinical trials with the non-radiopaque etonogestrel implant (IMPLANON®), the etonogestrel levels in blood decreased below sensitivity of the assay by one week after removal of the implant.
A woman should restart contraception immediately after removal of NEXPLANON if continued contraceptive protection is desired.
Failure to remove the implant may result in continued effects of etonogestrel, such as compromised fertility, ectopic pregnancy, or persistence or occurrence of a drug-related adverse event.
NEXPLANON is indicated for use by women to prevent pregnancy.
Selected Safety Information
NEXPLANON should not be used in women who have known or suspected pregnancy; current or past history of thrombosis or thromboembolic disorders; liver tumors, benign or malignant, or active liver disease; undiagnosed abnormal genital bleeding; known or suspected breast cancer, personal history of breast cancer, or other progestin-sensitive cancer, now or in the past; and/or allergic reaction to any of the components of NEXPLANON.
WARNINGS AND PRECAUTIONS
Complications of Insertion and Removal
NEXPLANON should be inserted subdermally so that it will be palpable after insertion, and this should be confirmed by palpation immediately after insertion. Failure to insert NEXPLANON properly may go unnoticed unless it is palpated immediately after insertion. Undetected failure to insert the implant may lead to an unintended pregnancy. Failure to remove the implant may result in continued effects of etonogestrel, such as compromised fertility, ectopic pregnancy, or persistence or occurrence of a drug-related adverse event.
Complications related to insertion and removal procedures, such as pain, paresthesias, bleeding, hematoma, scarring, or infection, may occur. If NEXPLANON is inserted deeply (intramuscular or in the fascia), neural or vascular injury may occur. Implant removal may be difficult or impossible if the implant is not inserted correctly, inserted too deeply, not palpable, encased in fibrous tissue, or has migrated. If at any time the implant cannot be palpated, it should be localized and removal is recommended.
There have been postmarketing reports of implants located within the vessels of the arm and the pulmonary artery, which may be related to deep insertions or intravascular insertions. Endovascular or surgical procedures may be needed for removal.
Changes in Menstrual Bleeding Patterns
After starting NEXPLANON, women are likely to have changes in their menstrual bleeding pattern. These may include changes in frequency, intensity, or duration. Abnormal bleeding should be evaluated as needed to exclude pathologic conditions or pregnancy. In clinical studies of the non-radiopaque etonogestrel implant, reports of changes in bleeding pattern were the most common reason for stopping treatment (11.1%). Women should be counseled regarding bleeding pattern changes that they may experience.
Be alert to the possibility of an ectopic pregnancy in women using NEXPLANON who become pregnant or complain of lower abdominal pain.
Thrombotic and Other Vascular Events
The use of combination hormonal contraceptives increases the risk of vascular events, including arterial events (strokes and myocardial infarctions) or deep venous thrombotic events (venous thromboembolism, deep venous thrombosis, retinal vein thrombosis, and pulmonary embolism). It is recommended that women with risk factors known to increase the risk of venous and arterial thromboembolism be carefully assessed. There have been postmarketing reports of serious arterial thrombotic and venous thromboembolic events, including cases of pulmonary emboli (some fatal), deep vein thrombosis, myocardial infarction, and strokes, in women using etonogestrel implants. NEXPLANON should be removed in the event of a thrombosis. Due to the risk of thromboembolism associated with pregnancy and immediately following delivery, NEXPLANON should not be used prior to 21 days postpartum. Women with a history of thromboembolic disorders should be made aware of the possibility of a recurrence. Consider removal of the NEXPLANON implant in case of long-term immobilization due to surgery or illness.
If follicular development occurs, atresia of the follicle is sometimes delayed, and the follicle may continue to grow beyond the size it would attain in a normal cycle. Generally, these enlarged follicles disappear spontaneously. Rarely, surgery may be required.
Carcinoma of the Breast and Reproductive Organs
Some studies suggest that the use of combination hormonal contraceptives might increase the incidence of breast cancer, and increase the risk of cervical cancer or intraepithelial neoplasia. Women with a family history of breast cancer or who develop breast nodules should be carefully monitored.
NEXPLANON should be removed if jaundice occurs.
Elevated Blood Pressure
The NEXPLANON implant should be removed if blood pressure rises significantly and becomes uncontrolled.
Studies suggest a small increased relative risk of developing gallbladder disease among combination hormonal contraceptive users. It is not known whether a similar risk exists with progestin-only methods like NEXPLANON.
Birth Control and Pregnancy: How long does it take to become pregnant after going off contraception.
How long it takes to get pregnant after going off birth control methods like the pill, shot, implant, and the IUD.
Photo by Franz Grünewald, Art direction by Marta Pucci
HORMONAL BIRTH CONTROL
When to stop taking hormonal birth control if you want to get pregnant
When to stop taking hormonal birth control if you want to get pregnant A method-by-method breakdown.
by Kate Wahl — September 6, 2019
Reviewed by Sarah Toler, DNP, CNM
Created by Clue with financial support from Bayer AG
This article is also available in: português, español
Top things to know
Most people who stop taking birth control to try to get pregnant are successful within the first year
For some types of birth control, there can be a temporary delay in getting pregnant
The delay one may experience depends on the method
To get pregnant, you need to have sex in the “fertile window” of your cycle
Many of us spend years of our lives using birth control. But what happens if you decide you’d like to conceive? In this article, we will review the different kinds of birth control and what happens when you stop using them to try to get pregnant.
Will hormonal birth control affect my ability to become pregnant in the future?
No; most people who stop using any type of birth control become pregnant within a year of stopping. And, after two years, there isn’t a difference in the ability to conceive, between those who stop using hormonal birth control and those who stop using other methods, like condoms (1,2).
How long does it take to get pregnant after stopping hormonal birth control?
Because hormonal birth control affects the reproductive cycle, it can temporarily delay how long it takes to get pregnant. The number of months it takes to get pregnant after going off your hormonal birth control depends on the specific method you were using.
Getting pregnant after going off the shot, for instance, may take longer than getting pregnant after removing an IUD.
Below, we use research findings to break down the numbers on how long it takes for a person in their mid-20s to early 30s to become pregnant, for each type of hormonal contraceptive method. For reference, it takes people who are around that age an average of four months to become pregnant once they stop using barrier methods like condoms, or behavioral methods like natural family planning. (One study showed that 68% of these people conceive in three months, 81% conceive in six months, and 92% conceive in twelve months.) (3,4).
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Hormonal IUDs are inserted into the uterus and release progestin (5). It takes an average of four months to get pregnant after the removal of a hormonal IUD (6).
38% to 43% of people conceive within 3 months
56% to 65% of people conceive within 6 months
79% to 96% of people conceive within 12 months (7,8).
The copper IUD is non-hormonal, so users tend to experience a faster return to fertility.
50% and 58% of people conceive within 3 months
72% to 75% of people conceive within 6 months
71% to 91% of people conceive within 12 months (1,6,9).
Hormonal Birth Control
What it’s like to have a hormonal IUD
We reached out seeking your personal stories. Here’s what came in.
by Jen Bell
Combination pills contain a combination of the hormones estrogen and progestin (10). People who stop taking combination pills take an average of eight months to get pregnant (4).
52 to 57 percent of people conceive in 3 months
71 to 83 percent of people conceive in 6 months
77 to 94 percent of people conceive in 12 months (5,11,12).
Injectable birth control contains progestin with or without estrogen and, depending on the specific type, is taken every one to three months (13). It can take an average of 5 to 9 months to get pregnant once you skip a shot to try and conceive. So, if you usually take a shot every 3 months, it would take about 8 to 12 months after the last shot you took to get pregnant (4,10).
Counting from the date of the first skipped shot:
23% to 35% of people conceive in 3 months
52% to 59% of people conceive in 6 months
77% to 82% of people conceive in 12 months (10,14,15).
Within two years of stopping the shot, about 92% of people will conceive (10,15).
Birth control implants are inserted under the skin and release progestin (16). After removing an implant, it takes an average of 3 to 8 months to get pregnant (1).
38% to 50% of people conceive within 3 months
63% to 77% of people conceive within 6 months
77% to 86% of people conceive within 12 months (17–20).
Two years after the implant is removed, about 90% of people will conceive (18–20).
Hormonal Birth Control
What it’s like to use a birth control implant
We reached out seeking your experiences with the implant. Here’s what came...
by Jen Bell
Progestin-only Pills, The Ring & The Patch
There is not a lot of research about these types of birth control. In one study, people who stopped taking progestin-only pills took about as long to get pregnant as those who stopped using condoms (4).
Does using emergency contraception (the morning after pill) affect my future fertility ?
According to the World Health Organization, taking emergency contraceptive pills does not affect the ability to get pregnant in the future (21).
When Fertility Will Return After Stopping Birth Control
After stopping birth control, you may be wondering how long it takes to get pregnant. Learn when fertility returns with each birth control method.
SEXUAL HEALTH BIRTH CONTROL
When Does Fertility Return After Stopping Birth Control?
By Dawn Stacey, PhD, LMHC Updated on December 02, 2021
Medically reviewed by Anita Sadaty, MD
Table of Contents
How Long Will It Take?
Fertility Return by Method
Other Factors to Consider
Fertility Does Not Equal Pregnancy
Frequently Asked Questions
Birth control lets you decide if and when to get pregnant. If you're like many people, you may spend years using birth control to prevent pregnancy.
But what happens when you're ready to get pregnant? Will you be able to get pregnant right away after you stop using birth control? Is it as easy as stopping the pill or not inserting another NuvaRing? The best answer we can give you is "it depends."
There are many misconceptions about how easy it is to get pregnant once you have stopped birth control. This article discusses different birth control methods and how quickly you can expect fertility to return after stopping them. It also looks at some other factors that may affect fertility.
Andersen Ross / Getty Images
How Long Will It Take to Get Pregnant?
Most hormonal birth control methods stop you from ovulating, or releasing an egg.1 If you do not release an egg, there is nothing for sperm to fertilize. This is why you do not get pregnant.
When you stop using hormonal birth control, you will start ovulating again. When you are ovulating, you are fertile. But a return of fertility does not automatically mean you will get pregnant.
Hormonal birth control methods stop ovulation. That is how they prevent pregnancy.
Fertility Return by Birth Control Method
When you regain your fertility, your body begins to ovulate again. Then, you can get pregnant. How long it takes depends on what birth control method you were using. Let's compare.
Barrier Methods and Natural Methods
If you were using a barrier method, there is good news. These methods do not interfere with fertility. Barrier methods include:
Condoms Female condoms Diaphragms Spermicide
Barrier methods block sperm from reaching your egg. These methods do not stop ovulation. Whether you are using them or not, your monthly cycle does not change.
As an added bonus, condoms also protect you from sexually transmitted infections (STIs). Left untreated, some STIs can lead to infertility.2
Some people use natural family planning methods. If this is you, you may be able to get pregnant faster. Many of these methods have you keep track of your most fertile days. So now, just do the reverse. Instead of avoiding sex around those days, go try to make a baby.
Natural Birth Control Methods
Combination Birth Control Methods
Combination birth control methods include combination birth control pills, NuvaRing, and the patch. Unfortunately, there is a lot of misinformation out there about these methods.
You may have heard it takes at least three months for ovulation to start up again after you stop the pill. This is not usually true. For most people, ovulation will start within weeks. For some, though, it can take one to three months.
Think about it like this: The pill works because it stops ovulation. If you miss a couple of pills, you might ovulate and you might get pregnant. Some healthcare providers even say you are most fertile just after you stop taking the pill.
So where does the “three-month myth” come from? Your healthcare provider may tell you to use a condom (or another over-the-counter method) until you have had three periods. This is just because waiting will help you keep track of your cycle. That way, if you get pregnant, it will be easier to guess when the pregnancy happened.
There is no medical reason to wait after you stop birth control before trying to become pregnant. Just be prepared that your fertility may return within the first month.
NuvaRing and the Patch work the same way as the pill, so the same goes for these methods. Fertility should return quickly. Most research shows that 80% of people who stop using these methods and want to get pregnant will get pregnant within the first year. This number is the same as that of the general population.3
This also seems true for other types of birth control pills. When you stop progestin-only or extended-cycle pills, your fertility should return quickly.
IUDs have a scandalous reputation. You may believe they cause pelvic inflammatory disease, which leads to infertility. This is also not true.
There are two types of IUDs:
Hormonal (Mirena and Skyla)
Non-hormonal copper (ParaGard).4
You can have your IUD removed at any time by a qualified healthcare provider. Please do not try to take it out yourself. Fertility returns very quickly after removing an IUD, usually within a month. This is true for both types of IUDs. Your uterus just needs time to get used to the IUD not being there anymore.
Research shows that once an IUD is removed, pregnancy rates are about the same as the rest of the population.5