What if I Get Pregnant with an IUD? (Odds and Side Effects)

Updated: April 3, 2022
Understand the odds of getting pregnant with an IUD and the affect of hormonal and copper IUDs on pregnancy
Table of contents

Pregnancy is always a concern when you are sexually active. Until you are ready to take on this life-changing responsibility, prevention is key. An IUD is one of the top birth control methods on the market thanks to its exceptionally low failure rate and the fact that you can remain safe for years at a time with minimal effort. However, on rare occasions, pregnancy can occur. If you find yourself wondering, “what if I get pregnant with an IUD?”, we have the details on why this could happen and what to do if you are part of that small percentage that finds themselves in this predicament.

Types Of Birth Control & Their Effectiveness

For those who want to practice safe sex and prevent pregnancy, there are an array of options on the market. According to Planned Parenthood, condoms are 85% effective and birth control pills are 91% effective. However, these forms of contraception can fail due to user error. Even with the best intentions, condoms can break. Moreover, the pills have to be administered at the same time every day. Late and missed doses can lead to pregnancy.

This is why many doctors advise choosing more permanent preventative measures. The patch and the vaginal ring tend to be slightly more effective due to their weekly and monthly applications, but they still only prevent pregnancy 91% of the time.

The birth control shot is slightly better at 94% and it lasts up to three months. Nevertheless, the most effective methods of birth control are the implant and the IUD. These options last for years and the processes are reversible. Compared to their competition, these contraceptives have more than 99% efficacy.

It is important to remember that all forms of birth control have their pros and cons, so it is imperative to do your research. In addition, when looking for the best birth control method for you, take the time to discuss your options, the potential side effects, and the possible issues that can arise with your physician before making any final decisions.

What Is An IUD?

What is an IUD

An Intrauterine Device otherwise referred to as an IUD, is an extremely effective form of birth control that is implanted in the uterus. This T-shaped device works in two ways. When using a hormonal IUD, the hormone levonorgestrel (or progestin) is slowly released into your body, causing it to produce a thicker cervical mucus. This helps to inhibit the sperm from reaching the egg. In contrast, the copper IUD affects sperm motility and the viability of the egg. Either way, without a fertilized egg, pregnancy cannot occur.

Both of these devices have to be inserted into the uterus by your OB-GYN. However, once removed, you can then go on to have a healthy pregnancy. For those looking to prevent conception for extended periods of time, these are more successful than most other types of contraception and they can be left in place for up to 10 years.

What Causes IUD Failures?

It is important to remember that no form of birth control is 100% effective. This includes intrauterine devices. Here are some of the rare instances that can cause this form of contraception to fail.

The Device Is Not Fully Effective Yet

The type of IUD that you have can impact when you can have sex without the worry of pregnancy. ParaGard is the only copper IUD available in the nation. It is also the only IUD that begins working the moment it is inserted. In fact, it is so effective at preventing pregnancy, that it can actually be used as a form of emergency contraception when placed in the uterus within five days of unprotected sex.

Conversely, hormonal IUDs require that the IUD insertion occurs within a week of the start of your period in order to be effective immediately. The Mayo Clinic notes that if any of these devices are “inserted more than seven days after the start of your period, be sure to use backup contraception for one week.” When this advice is not taken, pregnancy can occur.

Improper IUD Placement Due To Migration

Improper Placement

The proper placement is key to the IUD’s effectiveness. Once you choose to use this form of birth control, your healthcare professional will place the device at the fundus of the uterus. This is the top of the organ in between where the fallopian tubes attach.

Unfortunately, even when an experienced doctor places the IUD accurately in place, the device can move into the cervix or other parts of the body. Women younger than 25 and those with severe period cramps or heavy bleeding are more at risk for this movement. Certain medications and herbal supplements have also been shown to interact with hormonal therapies.

Anatomical Anomalies

Anatomical anomalies are another cause for the device to migrate outside of the uterus. According to the American Journal of Obstetrics & Gynecology, “retroflexed uterine positions and all uterine malformations are associated with higher incidence of malpositioned intrauterine devices.”

What this means is that if your uterus has a natural backwards tilt or if you have uterine fibroids, you are at a higher risk of expelling the device or having it move where it doesn’t belong.

Timing After Childbirth

Movement of the device can also occur when the IUD is placed in the uterus too soon after childbirth. While you can have one inserted immediately after and up to 48 hours following your delivery, there is a larger chance for expulsion when it is inserted at this time. Thus, it is best to wait until four to six weeks after giving birth.

Watch Out For These Symptoms

Signs that migration has occurred include missing IUD strings, heavy vaginal bleeding, abnormal vaginal discharge, and pelvic pain or severe cramping. These symptoms all warrant a call to your healthcare provider.

An Expired Device

While intrauterine devices are long-acting, it is important to pay attention to the date that you initially had it inserted. The copper IUD will remain effective for up to ten years. However, depending on the brand of hormonal IUD that you choose, the length of effectiveness can vary greatly.

The Mayo Clinic notes that you will have efficacy for “up to 3 years for Skyla®, up to 5 years for Kyleena®, up to 6 years for Liletta®, or up to 7 years for Mirena®.” No matter if you choose a hormonal or non-hormonal IUD, once expired, you run the risk of infection and pregnancy.

Pregnancy & Intrauterine Devices

Pregnancy and IUD

While extremely rare, pregnancy can occur with an IUD. If you find yourself in this scenario, it is imperative that you talk to your OG-GYN immediately. Unfortunately, when you get a positive result on a home pregnancy test with an IUD in place, a large percentage of the time the pregnancy is extrauterine. More commonly referred to as ectopic pregnancy, this is a life-threatening condition that needs to be addressed immediately.

That is not to say that all pregnancies will turn out this way, but it is always best to err on the side of caution since the risk of ectopic pregnancy is higher in women who use an IUD as their main form of contraception. Your doctor will conduct an ultrasound and an exam to determine if the pregnancy is viable or not.

If they determine that the implantation occurred effectively, you can go on to have a healthy pregnancy. In this instance, it is recommended that the IUD is removed immediately. This will allow you to achieve an optimal outcome for you and your baby.

Research shows that “women who conceived with an IUD in place and chose to continue the pregnancy without removing the IUD need close follow-up, as there appears to be a higher risk of adverse pregnancy and neonatal outcome.” This is especially true when the IUD has moved out of place and into the cervix. This position can increase your risk of miscarriage.

However, if the device has migrated to a location that would require an invasive procedure that could impact the fetus, your doctor may decide to leave the device in place.

Final Thoughts

Every form of birth control has its benefits and pitfalls. For those who are forgetful when it comes to taking pills or suffer from endometriosis, an intrauterine device is a recommended contraceptive tool. Moreover, for those who have suffered a stroke and cannot take hormonal birth control options, the copper IUD is a much more effective alternative to condoms or other barrier methods.

Just remember to pay close attention to your doctor’s instructions immediately following the insertion. Inquire about what symptoms are normal following the procedure and what is cause for concern. This can help you to address issues head-on and prevent accidental pregnancy.