Does Birth Control Affect Fertility? What Science Says About Long-Term Use and Getting Pregnant After Stopping

Birth control pills have been a revolutionary advancement in reproductive health, giving millions of women control over family planning. I, myself, was on birth control for at least 15 years, originally starting as it helped alleviate debilitating cramping I experienced around my period.

When my husband and I were ready to start trying for a baby, I remember the rush of excitement I felt when I threw out my pack of birth control pills—like I was living on the edge and could get pregnant at any moment.  But I did have a nagging feeling in the back of my mind as I wondered how soon I could get pregnant after stopping birth control. Could my years of birth control use negatively affect my fertility? 

The good news is that scientific research overwhelmingly shows that no, birth control does not cause infertility. In this article, we’ll break down how birth control works, what happens when you stop using it, and what factors actually *do* influence fertility. 

How birth control works

Birth control methods vary widely in form and function, but the most common types include:

• Combination birth control pills: Contain synthetic estrogen and progestin, preventing ovulation and thickening cervical mucus to block sperm.
• Progestin-only pills (mini-pills): Prevent pregnancy primarily by thickening cervical mucus and sometimes suppressing ovulation.
• Long-acting reversible contraceptives (LARCs): Include intrauterine devices (IUDs) and implants, which provide extended protection without requiring daily adherence.
• Injectable contraception (Depo-Provera):  A progestin shot given every three months to prevent ovulation.
• Other hormonal methods: Such as patches, vaginal rings, and hormonal IUDs, all of which work through hormonal suppression of ovulation and sperm-blocking mechanisms.

These methods are designed to be fully reversible, meaning fertility should return once you stop using them. Your body may need a few months to regulate after stopping your birth control, but if your irregularity continues, consult your OBGYN. More on that below. 

Can being on birth control for years impact fertility? The answer is no

A common myth is that long-term use of birth control can lead to infertility. However, multiple studies have shown that birth control does not have a lasting impact on a woman’s ability to conceive.

A study published in Human Reproduction found that previous use of oral contraceptives did not impair fertility. Another recent comprehensive review in the British Medical Journal confirmed that conception rates among women who had used birth control were comparable to those who had never used it.

Ask any OBGYN, and they will tell you the same thing: birth control is safe, effective, and will not negatively impact your long-term fertility.

Return to fertility after discontinuing birth control

Many people worry: is it hard to get pregnant after years of birth control pills? 

The answer is no. However, while birth control does not directly impact your fertility, taking it might mask other cycle irregularities or symptoms you’d otherwise experience that may impact your ability to conceive. 

Depending on the type of birth control used, the potential time to get pregnant after stopping birth control may vary. If you take birth control pills or have an IUD (hormonal or copper), your fertility *should* (key word here) return anywhere between immediately and within a few weeks. If you have an implant, like Nexplanon®, ovulation usually resumes within one to three months after removal. Depo-Provera® users experience the longest delay, with some women taking up to 18 months for ovulation to return. However, eventual fertility rates remain unchanged.

All of this being said, a systematic review found that regardless of the contraceptive method, pregnancy rates after discontinuation were comparable to those who had never used contraception. 

Read more in I’m Going Off Birth Control. Now What?

Stopping birth control? Pregnancy is a risk

If you’re discontinuing birth control but are not trying to conceive, it’s important to use alternative contraceptive methods. Ovulation can return sooner than expected, even within days of stopping the pill or removing an IUD. To prevent unintended pregnancy, consider using barrier methods like condoms or exploring non-hormonal options until you are ready for a planned pregnancy.

Factors that actually impact fertility

While birth control does not cause infertility, several other factors can significantly affect your ability to conceive:

• Age: Female fertility declines with age, particularly after 35, due to a decrease in egg quantity and quality. 
• Underlying medical conditions: Conditions like polycystic ovary syndrome (PCOS), endometriosis, and thyroid disorders can affect fertility.
• Lifestyle factors: Smoking, excessive alcohol consumption, obesity, and chronic stress can all impact reproductive health.
• Male fertility: Sperm health is equally important; issues like low sperm count or motility can affect conception rates.

If you’re concerned about fertility, speaking with your OBGYN or a reproductive endocrinologist (REI) can provide personalized guidance based on your health and family planning goals.

Preserving your fertility with egg freezing

Even if you’re unsure whether you want children in the future, freezing your eggs can help keep your options open. Advances in egg freezing have made it a viable choice for many women. However, due to cost, it’s still relatively inaccessible to many. 

At Cofertility, we can help you freeze your eggs for free when you donate half of the eggs retrieved to another family who can’t conceive. This approach, known as our Split program, allows women to preserve their fertility while helping others grow their family — like gay dads, those with infertility, and cancer survivors. Take our quiz to see if you qualify for free egg freezing today.

Summing it up

The belief that birth control negatively impacts long-term fertility is a myth. Research consistently shows that—for most women—fertility returns soon after discontinuing contraceptive methods, and birth control use does not make it harder to conceive in the future.

However, factors like age, medical conditions, and lifestyle choices play a significant role in fertility outcomes. If you’re thinking about your reproductive future, egg freezing with Cofertility could be a valuable option. Whether or not you’re ready to have children, taking steps to preserve your fertility today can provide some peace of mind for the future.