Can I get pregnant right after removing the IUD?

The intrauterine device (IUD) is one of the most effective reversible methods of contraception available. It is placed in the uterine cavity and works locally to prevent fertilization and, in some cases, implantation. A common question among patients planning pregnancy is whether fertility returns immediately after IUD removal, and whether conception can occur right away. This article reviews the mechanism of action of IUDs, what happens after removal, the timeline for return to fertility, clinical recommendations for preconception care, and practical considerations for removal and follow‑up. Information and guidance are based on professional sources including the American College of Obstetricians and Gynecologists (ACOG), the National Institutes of Health (NIH/MedlinePlus and PubMed resources), the Mayo Clinic, and the Cleveland Clinic.

Types of IUDs and how they work

There are two main types of intrauterine devices in clinical use:

Copper IUD (non‑hormonal): A small T‑shaped device wrapped with copper. It produces a local inflammatory reaction in the endometrium and uterine cavity that is toxic to sperm and ova and prevents fertilization. The copper IUD may also prevent implantation in some cases. (Mayo Clinic: IUD overview)

Levonorgestrel‑releasing IUD (hormonal): A T‑shaped device that releases small amounts of the progestin levonorgestrel locally into the uterine cavity. It thickens cervical mucus, reduces endometrial receptivity, and may inhibit or alter ovulation in some users. Several commercial devices exist with different levonorgestrel doses and durations of approved use. (ACOG Practice Bulletin: Long‑Acting Reversible Contraception)

Both types are long‑acting, highly effective, and intended to be reversible; when the device is removed, its contraceptive effect ends.

(ACOG, Practice Bulletin: Long‑Acting Reversible Contraception; Mayo Clinic: Intrauterine device (IUD)).

Effectiveness while in place — and what removal means

IUDs are among the most effective contraceptives. Typical use failure rates are well under 1% per year for both copper and levonorgestrel IUDs. Because the device acts locally and continuously while in place, it reliably prevents pregnancy until it is removed.

When the IUD is removed by a clinician, the mechanical and biochemical effects of the device cease. Therefore, a woman’s fertility is no longer suppressed by the IUD and she can become pregnant if ovulation and unprotected vaginal intercourse occur at the appropriate time in her cycle.

(Mayo Clinic; Cleveland Clinic: Intrauterine Device (IUD))

Can you get pregnant immediately after removal?

Yes. Conception can occur immediately after IUD removal.

Ovulation can resume rapidly. Fertility returns quickly after removal of both copper and levonorgestrel IUDs. Some women ovulate within weeks — or even days — after removal, and conception can occur in the first cycle after removal. (ACOG; NIH/MedlinePlus)

There is no medically required waiting period after IUD removal before trying to conceive. Professional guidance does not require a delay; many clinicians advise that if you wish to become pregnant, you may begin attempting pregnancy immediately after the device is removed. (ACOG Practice Bulletin; Mayo Clinic)

The timing of conception depends on where a woman is in her menstrual cycle at the time of removal. If removal is performed just before or during the fertile window (the days leading up to and including ovulation), pregnancy may occur that cycle.

(ACOG; Mayo Clinic; MedlinePlus)

Differences between copper and levonorgestrel IUDs in return to fertility

Both copper and levonorgestrel IUDs are associated with rapid return to fertility when removed, but there are some clinical nuances:

Copper IUD: Because copper IUDs do not reliably suppress ovulation, ovarian function typically remains normal while the device is in place. After removal, normal cycles usually continue and conception can occur immediately. (ACOG; NIH)

Levonorgestrel IUD: The levonorgestrel IUD primarily acts locally; systemic progestin levels are low. While some users may experience changes in bleeding patterns (lighter periods or amenorrhea), most users resume ovulation and fertility soon after removal. A small subset of women may have a transient delay in the return of regular menses, but that does not generally prevent conception. Multiple studies show similar pregnancy rates after removal of levonorgestrel IUDs compared with copper IUDs and other contraceptive methods. (ACOG; Cleveland Clinic)

Overall, neither IUD type is associated with long‑term impairment of fertility in the absence of other factors.

(ACOG; Cleveland Clinic; NIH PubMed resources)

How quickly does ovulation return?

The interval between IUD removal and the first post‑removal ovulation varies among individuals:

Some women will ovulate in the same menstrual cycle during which the IUD is removed.

Others may take a few weeks to have their next ovulation, especially if they had amenorrhea while using a levonorgestrel IUD.

On average, most women who desire pregnancy will conceive within months after removal, with many achieving pregnancy within the first three to six cycles if there are no other fertility issues.

There is no specific clinical waiting period recommended to allow “clearing” or “detoxifying” after IUD removal; immediate attempts are reasonable. (ACOG; Mayo Clinic; NIH)

Fertility outcomes after IUD use — what does the evidence show?

Large cohorts and systematic reviews indicate that prior use of IUDs does not reduce future fertility for most women:

Studies comparing time to pregnancy after discontinuation of various contraceptives generally show no meaningful long‑term adverse effects after removal of an IUD compared with other reversible contraceptives. (NIH/PubMed literature reviews)

The primary exception relates to pelvic inflammatory disease (PID). If a woman contracts an untreated sexually transmitted infection (STI) such as chlamydia or gonorrhea at the time of IUD insertion — and the infection ascends to the fallopian tubes — there is a potential for tubal damage that can affect future fertility. However, routine IUD use in women without active STIs is not associated with increased risk of PID or long‑term infertility. (ACOG; CDC)

Women with a prior history of PID, tubal surgery, endometriosis, or other infertility risk factors will have fertility outcomes influenced by those conditions independent of IUD use. (ACOG; Cleveland Clinic)

In summary, IUD use itself is not associated with long‑term infertility in otherwise healthy women.

(ACOG; CDC; NIH)

Risk of ectopic pregnancy after IUD removal

Ectopic pregnancy risk considerations:

While IUDs are highly effective at preventing intrauterine pregnancy, a pregnancy that occurs while an IUD is in place has an increased relative likelihood of being ectopic compared with pregnancies conceived without an IUD. However, because overall pregnancy rates with an IUD are very low, the absolute risk of ectopic pregnancy is low. (ACOG; CDC)

After removal of an IUD, the risk of ectopic pregnancy returns to baseline for the population and is not increased by prior IUD use alone. Women with known tubal disease or prior ectopic pregnancy remain at higher risk and should be counselled accordingly. (ACOG; Mayo Clinic)

If pregnancy occurs soon after removal and there is concern about pain or abnormal bleeding, evaluation for ectopic pregnancy is indicated.

(ACOG; Mayo Clinic; CDC)

Clinical recommendations before attempting conception

If you are planning to conceive after IUD removal, consider the following preconception interventions commonly recommended by clinicians:

Preconception visit: Schedule a visit with your obstetrician/gynecologist or primary care clinician to review medical history, medications, screenings, vaccinations, and optimization of chronic conditions. (ACOG; CDC)

Folic acid: Start folic acid supplementation (0.4–0.8 mg daily for most women; higher doses may be recommended for women with prior neural tube defect or other risk factors) at least one month prior to conception if possible to decrease the risk of neural tube defects. (ACOG; NIH)

Immunizations: Confirm immunity to rubella (MMR), varicella, and other relevant vaccines. Live vaccines (e.g., MMR) should be administered before pregnancy with appropriate timing (avoid conception for 28 days after MMR). Influenza and Tdap vaccinations are recommended during pregnancy as per guidelines. (CDC; ACOG)

Screening for STIs: Screen and treat chlamydia and gonorrhea as indicated prior to conception, particularly if there is STI risk. Untreated STIs can lead to tubal damage and adverse pregnancy outcomes. (ACOG; CDC)

Medications and exposures: Review medications, supplements, and occupational exposures for teratogenic risk. Adjust therapy for chronic conditions (e.g., diabetes, hypertension, thyroid disease) to pregnancy‑safe regimens and target levels prior to conception. (ACOG; NIH)

Lifestyle optimization: Counsel on cessation of tobacco, moderation or avoidance of alcohol, and achieving a healthy weight. Assess and optimize nutritional status (iron, vitamin D as indicated). (ACOG; NIH)

Reproductive age counseling: Age is a major determinant of fertility. Women aged 35 and older may have diminished ovarian reserve and should discuss timing and possible fertility evaluation if conception is not achieved within an appropriate time frame. (ACOG; NIH)

A planned, proactive approach improves maternal and fetal outcomes and may help reduce time to a healthy pregnancy.

(ACOG; CDC; NIH; Mayo Clinic)

Practical aspects of IUD removal

Setting and procedure: IUD removal is typically performed in an outpatient clinic. A speculum is used to visualize the cervix, and the provider gently removes the device by traction on the IUD strings. Removal is usually quick; some women experience cramping similar to a strong menstrual cramp. (Mayo Clinic; Cleveland Clinic)

Timing of removal relative to attempting conception: If you wish to conceive right away, you can schedule removal when you are ready to attempt pregnancy. If you are not planning pregnancy, discuss and initiate an alternative contraceptive method before removal if you want to avoid immediate fertility. (ACOG; Mayo Clinic)

If strings are not visible: Occasionally the IUD strings are not easily visualized. In such cases, the provider may perform an ultrasound to confirm device location. If the device cannot be removed in office or is embedded/partially expelled, additional procedures (e.g., hysteroscopic removal) may be required. (ACOG; Cleveland Clinic)

Post‑removal symptoms: Mild cramping or brief bleeding may follow removal. Seek medical attention if you develop fever, heavy bleeding, severe pain, or foul discharge, which could indicate infection or other complications. (Mayo Clinic; Cleveland Clinic)

What to do if pregnancy occurs with the IUD still in place

Although uncommon, pregnancy can occur with an IUD in place. The general recommendations are:

If pregnancy is confirmed and the IUD strings are visible or the device can be removed easily without disturbing the pregnancy, removal is usually advised because continuing pregnancy with an intrauterine device in place increases the risk of miscarriage, infection, and preterm birth. The clinician will balance the risk of removal (which may increase miscarriage risk if the device is removed) against the risk of leaving it in place. (ACOG)

If the IUD cannot be safely removed and is left in situ, close monitoring for complications is required. Patients should be counseled about signs of infection and monitored with appropriate obstetric care. (ACOG; CDC)

If an ectopic pregnancy is diagnosed, management follows standard ectopic pregnancy protocols. (ACOG)

(ACOG Practice Bulletin: IUDs and Pregnancy Management)

When to seek fertility evaluation

Most healthy couples conceive within 6–12 months of timed attempts. Clinical recommendations for fertility evaluation after IUD removal are similar to general infertility guidelines:

Women under age 35: Consider fertility evaluation after 12 months of regular, unprotected intercourse without conception. (ACOG)

Women age 35 or older: Consider evaluation after 6 months of regular, unprotected intercourse without conception because fertility declines with age. (ACOG; NIH)

Earlier evaluation may be warranted if there are known risk factors such as a history of pelvic infection, prior pelvic surgery, irregular or absent ovulation, known male factor concerns, or other clinical indicators.

(ACOG; NIH)

Common questions patients ask

Do I need to wait a few cycles after removal for my body to “reset”? No medical requirement exists to wait. Most women can attempt conception immediately after removal. If you have amenorrhea or irregular bleeding after a levonorgestrel IUD, you may still ovulate and can conceive before menses resumes.

Does prior IUD use increase the chance of infertility? Not when the device was used appropriately and without associated complications. The exception is prior or untreated pelvic infection at or near the time of insertion that led to tubal damage. Routine IUD use is not linked to decreased long‑term fertility. (ACOG; CDC)

Should I have testing before removing the IUD? Routine screening is individualized. Many clinicians perform preconception counseling and may offer STI screening, rubella immunity testing, and medication review. Vaccination and optimization of chronic conditions are commonly addressed before planned conception. (ACOG; CDC; NIH)

Key risks and complications to be aware of

Infection: Risk of pelvic infection associated with IUD insertion is low. Prompt diagnosis and treatment of STIs is important because ascending infection can result in tubal damage. (ACOG; CDC)

Perforation: Uterine perforation at the time of insertion is rare. If perforation occurs and the device is not located within the uterine cavity, surgical removal may be necessary. Perforation is not a common cause of subsequent infertility when appropriately managed.

Expulsion: Partial or complete expulsion of the IUD can occur, which increases the risk of unintended pregnancy while the device is not in place. If expulsion is suspected, prompt evaluation is indicated. (Mayo Clinic)

Device embedded in myometrium or not retrievable in office: Rarely, the IUD may be embedded or difficult to retrieve; hysteroscopy or minor operative procedures may be required for safe removal.

(ACOG; Mayo Clinic; Cleveland Clinic)

Summary and practical recommendations

Fertility generally returns rapidly after IUD removal. Conception can occur immediately — there is no required waiting period after removal. (ACOG; Mayo Clinic)

Both copper and levonorgestrel IUDs are reversible, and prior use does not usually impair future fertility, except where there is a history of pelvic infection that caused tubal damage. (ACOG; CDC)

If you plan to conceive, consider a preconception visit to optimize health (folic acid, immunizations, chronic disease control, medication review, and STI screening). (ACOG; NIH)

If you do not wish to conceive immediately after removal, arrange an alternate method of contraception before or at the time of removal.

If pregnancy occurs soon after removal and you experience pain, bleeding, or other concerning symptoms, seek medical evaluation to rule out complications including ectopic pregnancy.

If you have specific health concerns, a history of pelvic infection, prior pelvic surgery, or other risk factors for infertility, discuss them with your clinician before removal so that individualized planning and testing can be arranged.

References and further reading:

ACOG Practice Bulletin: Long‑Acting Reversible Contraception (LARC). American College of Obstetricians and Gynecologists. (https://www.acog.org)
MedlinePlus: Intrauterine Device (IUD). National Library of Medicine / NIH. (https://medlineplus.gov)
Mayo Clinic: Intrauterine device (IUD). (https://www.mayoclinic.org)
Cleveland Clinic: Intrauterine Device. (https://my.clevelandclinic.org)
Centers for Disease Control and Prevention (CDC): Contraception and STI guidance. (https://www.cdc.gov)

(For the most current and individualized medical advice, consult your healthcare provider.)