Read on to learn why this happens, your options for emergency contraception, when to take a pregnancy test, and more.
Here’s What You Should Know About Getting Pregnant with an IUD
An intrauterine device (IUD) is a type of long-acting birth control. It’s a small device that your doctor can put into your uterus to prevent pregnancy. There are two main types: copper IUDs (ParaGard) and hormonal IUDs (Kyleena, Liletta, Mirena, Skyla).
Both types of IUD are more than 99 percent effective at preventing pregnancy, according to Planned Parenthood. Over the course of a year, fewer than 1 out of 100 women with an IUD will get pregnant. That makes it one of the most effective forms of birth control.
In very rare cases, it’s possible to get pregnant while using an IUD. If you do get pregnant while using an IUD, you’re more likely to have an ectopic pregnancy or miscarriage. But your overall risk of experiencing these complications is low.
Ectopic pregnancy happens when a pregnancy develops outside your uterus. For example, it can happen if a fertilized egg starts to grow in your fallopian tube.
Ectopic pregnancy is rare but serious. If left untreated, it can cause internal bleeding and infection. In some cases, it can even be fatal.
If you get pregnant while using an IUD, the device raises the chances that your pregnancy will be ectopic. But if you have an IUD, your risk of getting pregnant in the first place is low. In turn, your overall risk of ectopic pregnancy is also low.
According to scientists in the International Journal of Women’s Health , ectopic pregnancy affects an estimated 2 out of 10,000 women with a hormonal IUD each year. It affects an estimated 5 out of 10,000 women with a copper IUD each year.
In comparison, more than 1 out of 100 sexually active women who don’t use birth control will have an ectopic pregnancy over the course of a year.
A miscarriage happens if a pregnancy ends spontaneously before its 20th week. At that point, the fetus isn’t developed enough to survive outside the uterus.
If you get pregnant while using an IUD, the device increases the risk of miscarriage. If you want to stay pregnant, it’s important to remove the IUD early in pregnancy.
Sometimes, an IUD can slip out of place. If that happens, the risk of pregnancy is higher.
To check the placement of your IUD:
- Wash your hands with soap and water.
- Get into a comfortable sitting or squatting position.
- Insert your index or middle finger into your vagina. You should be able to feel the string attached to your IUD, but not the hard plastic of the IUD itself.
Contact your doctor if:
- you can’t feel the IUD string
- the IUD string feels longer or shorter than it used to
- you can feel the hard plastic of the IUD coming out of your cervix
Your doctor can use an ultrasound exam to check the internal positioning of your IUD. If it has slipped out of place, they can insert a new IUD.
An IUD can work for years before you need to replace it. But eventually it expires. Using an expired IUD may raise your risk of pregnancy.
In most cases, a copper IUD can last for up to 12 years. A hormonal IUD can last for up to 3 years or longer, depending on the specific brand you use.
Ask your doctor when you should have your IUD removed and replaced.
The birth control effects of an IUD are completely reversible. If you want to get pregnant, you can remove your IUD at any time. After you remove it, you can try to get pregnant right away.
Can You Get Pregnant with an IUD in Place?
Yes, you can get pregnant while using an IUD — but it’s rare.
IUDs are more than 99 percent effective. This means that less than 1 out of every 100 people who have an IUD will become pregnant.
All IUDs — hormonal, non-hormonal, or copper — have a similar failure rate.
Read on to learn why this happens, your options for emergency contraception, when to take a pregnancy test, and more.
In a small number of people — between 2 and 10 percent — the IUD can slip partly or completely out of the uterus.
If this happens, you can get pregnant. You might not realize the IUD has fallen out of place.
In some cases, pregnancy can happen because the IUD hasn’t started to work.
The copper IUD, Paragard, protects against pregnancy immediately.
But hormonal IUDs, such as Mirena and Skyla, can take up to seven days to become effective. You could get pregnant if you have sex without a condom or other form of protection during this window.
You may also experience IUD failure if the IUD has been in place for longer than the manufacturer recommends.
Although one 2015 study found that Mirena may protect against pregnancy for a full year after its FDA-approved expiration date, more research is needed to confirm this finding.
If you suspect that your IUD has failed, talk to a doctor or other healthcare provider about using emergency contraception (EC).
EC will stop you from ovulating and prevent you from getting pregnant if your IUD has failed. It won’t end a developing pregnancy.
Your provider may recommend one of the following options:
Hormonal pills
As a rule of thumb, hormonal EC is most effective when taken within 72 hours of birth control failure.
However, you can still take hormonal EC for up to five days afterward.
You can purchase EC pills over the counter at your local pharmacy. If you’re insured, you may consider calling your doctor to get a prescription.
EC is considered preventive care, so you may be able to fill your prescription for free.
If you don’t have insurance, you may have access to a financial assistance program.
Copper IUD
If you have a hormonal IUD and suspect that it’s failed, talk to your doctor about switching to a copper IUD.
The copper IUD can prevent pregnancy if it’s inserted within five days of birth control failure.
The copper IUD can be left in for up to 10 years.
As with EC pills, the copper IUD may be available at a reduced rate through your insurance plan.
If you don’t have insurance, you may have access to a financial assistance program. Some birth control clinics will offer services even if you can’t pay.
If the pregnancy develops in your uterus, you may notice typical pregnancy symptoms, such as:
- missed periods
- nausea, possibly with vomiting
- sore, enlarged breasts
- tiredness
- mild cramps
- light spotting
Some of these symptoms — like cramping, spotting, and missed periods —can be similar to the side effects caused by your IUD.
If you don’t know what’s causing your symptoms, see a doctor or other healthcare provider.
Having an IUD in place may be slightly more likely to result in an ectopic pregnancy.
This occurs when the embryo implants outside of your uterus.
Symptoms of an ectopic pregnancy include:
- sharp waves of pain in your abdomen, pelvis, shoulder, or neck
- severe pain on one side of your abdomen
- vaginal spotting or bleeding
- dizziness
- fainting
- rectal pressure
An ectopic pregnancy is considered a medical emergency, so seek immediate medical attention if you’re experiencing any of these symptoms.
If you think you might be pregnant, take a home pregnancy test. These tests are available over the counter (OTC).
You can take an OTC test on the first day of your missed period.
If your IUD has caused your periods to be irregular — or to stop completely — you should wait to one to two weeks after you suspect your IUD failed to take an OTC test.
These tests are almost 99 percent accurate .
In most cases, a negative result means that you aren’t pregnant.
If you’re experiencing unusual symptoms or suspect that the test isn’t accurate, see a doctor.
If the test is positive, make an appointment with an OB-GYN or other healthcare provider. They’ll confirm the results with a urine or blood test and discuss next steps.
Your doctor will first double-check that you’re pregnant with a urine or blood test.
Pregnancy tests check for human chorionic gonadotropin. Your body only produces this hormone when you’re pregnant.
Your doctor will then do a pelvic exam. If your IUD string is visible, your doctor will remove the IUD. If your IUD string isn’t visible, they’ll perform an ultrasound to help locate your IUD. They may need to use a cytobrush or other tool to aid in removal.
Current guidelines suggest that the IUD should be removed before the end of the first trimester. Removing the IUD after this point may result in complications for both the person carrying the pregnancy and the pregnancy itself.
You should have the IUD removed regardless of whether you plan to keep or terminate the pregnancy.
An ultrasound will also help your doctor determine if the pregnancy is healthy or if there are problems, such as ectopic pregnancy.
If it’s ectopic, your doctor will recommend medication or surgery to remove the embryo. The exact treatment depends on the embryo’s location and overall development.
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Family Medicine
In 2024 our team of doctors and nurses provide a comprehensive range of family planning services. Our doctors have expertise in antenatal care, preconception planning, and STD checks. Contraceptive advice including Mirena and Implanon insertion is available.
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