Getting pregnant after the pill: how long does it take?

How does the pill work?

First of all let’s try to understand how oral contraceptives work , very common hormonal contraceptives that have their pros and cons.

The most common oral contraceptive is the combined pill , which contains two hormones: estrogen and progestin. Its main effect is to prevent ovulation and to thicken the cervical mucus every month. Without ovulation it is not possible to conceive a child and thick cervical mucus is inhospitable to sperms which are unable to return to the uterus.

If the pill is taken regularly and on time, the chances of pregnancy are reduced to almost zero.

Less commonly, the progesterone-only pill (often known as the minipill ) is prescribed , which is mainly used by women over 35 and breastfeeding mothers.

How long to wait to get pregnant after the pill? 

In theory, the search could start right away. However, experts recommend waiting 3 months after stopping the pill , for two main reasons:

• wait for the cycle to regularize in order to better identify ovulation . This will make it easier to identify the fertile period and to date the eventual pregnancy with greater accuracy;

• compensate for any deficits in certain micronutrients such as magnesium, vitamins B1, B2, B6, vitamin E, folic acid  (it should always be taken at least 2 months before starting the search for pregnancy and helps prevent malformations such as spina bifida ) and zinc (one of the most important nutrients for fertility). The pill, in fact, can cause deficiencies in these trace elements.

In this regard, we remind you that before stopping the contraceptive pill it is always important to consult your gynecologist first and in any case wait for the end of the blister .

Furthermore – and this also applies to those who do not use contraceptives such as the pill – before starting the research it is advisable to undergo a gynecological examination (the so-called preconception examination ), both to check up and to receive all the essential information for starting a pregnancy in the best way.

In particular, during this meeting the doctor will prescribe folic acid and all the  necessary preconception tests  (which are completely free).

When will menstruation return? 

When you stop taking the contraceptive pill, you have blood loss which is not real menstruation, but which is due to the hormones taken just before.

After the interruption, ovulation generally resumes the next cycle, therefore menstruation should return after 1 month (remember that the flow appears from 11 to 16 days after ovulation is ascertained).

Sometimes, the reactivation of the ovaries can take longer and consequently the cycle can be delayed for a few months, precisely because ovulation does not occur.

This post-pill amenorrhea is considered normal for up to 3 months, but it can last even longer if the ovaries are “sleeping good”. In any case, if menstruation does not occur 3 months after stopping the pill, it is advisable to consult your gynecologist.

I stopped taking the pill after so many years: will it be more difficult to get pregnant?

The answer is not unique. There are women who become fertile again immediately after stopping the pill.  Others are no longer able to ovulate for weeks or months , without it being possible to understand when the situation will normalize. In these cases, these are often women who had regularity problems even before the pill.

Also, even after the ovaries are reactivated, it may take time for a woman to produce fertile cervical mucus .

Prolonged intake of the pill for several years can in fact atrophy the crypts of the neck of the uterus that produce cervical mucus. And we know very well that cervical mucus is essential to allow sperm to move and make their journey towards the tubes and the egg to be fertilized.

In essence, each body therefore reacts differently  and it is good to know this when deciding to take a hormonal contraceptive.

Probability of getting pregnant after the pill

A 2009 study analyzed the pregnancy rate in 2,000 women who decided to stop using contraceptives after 7 years.

The results showed that:

• 21.1 % of women became pregnant during their first cycle after stopping;
• 79.4 % of women became pregnant within 1 year after stopping.

Factors affecting the likelihood of conceiving after stopping the pill

The possibility of conceiving after stopping the pill depends on many factors.

• Women’s general health : Thyroid or pituitary gland disorders, or polycystic ovary syndrome (PCOS) can affect your chances of conceiving. Obese or excessively thin women may also have difficulty conceiving.

• Women’s Reproductive Health : Women who have a history of pelvic infections or endometriosis may have an increased difficulty getting pregnant.

• Men’s Reproductive Health : Varicoceles, infections, and hormonal factors can negatively impact your chances of conceiving.

• Smoking: Research clearly shows that women and men who smoke are less likely to conceive.

• Intercourse frequency:  to increase the chances of pregnancy, you should have regular and frequent intercourse (every 2-3 days) between one menstrual period and the next, or use methods to target intercourse during the fertile period (preferably on days alternate ).

• Age of the woman : Pregnancy rates decrease after 35 years of age. According to the NHS , 92% of women aged 19-26 will conceive within 1 year of unprotected sex. This percentage drops to 82% for women aged 35 to 39.

• Age of men: it is less influential than women’s age, but it can help lengthen the research time