Becoming pregnant when you have an intrauterine device (IUD) isn't common, but it can happen. Find out the symptoms and implications of an IUD pregnancy.

By Elena Donovan Mauer
Updated February 24, 2020
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Credit: flocu/Shutterstock

An intrauterine device (IUD) is one of the most popular and effective forms of birth control—and it's rare to become pregnant while using one. "The IUD has a 99.7 percent efficacy rate," says Lanalee Araba Sam, M.D., an OB-GYN in Ft. Lauderdale. "Very, very few women with one will become pregnant. But I always tell my patients that someone on this planet is that one-in-a-million exception. There are instances where someone becomes pregnant with an IUD in place."

Heres' what you need to know about the symptoms of an IUD pregnancy and the complications that can emerge from one.

Will I Get My Period with an IUD?

Concerned that a missed period means you became pregnant with an IUD? Don’t fret just yet, since about 25 percent of women stop having their period while on Mirena (a type of IUD that uses the hormone progesterone to prevent pregnancy), says Cristina Perez, M.D., an OB-GYN at the Women's Specialists of Houston at Texas Children's Pavilion for Women.

The other type of IUD, ParaGard, relies on copper to prevent pregnancy. "ParaGard has no hormones," Dr. Perez explains, so if you're using it, you should still be getting your period as long as you're not pregnant.

Signs of Pregnancy with IUD

Pregnancy with an IUD typically has the same symptoms as a normal pregnancy, including breast tenderness, nausea, and fatigue. If you're experiencing those symptoms and have missed your period, call your doctor right away to find out if you're pregnant.

It's important to catch an IUD pregnancy early because of certain health concerns. An at-home pregnancy test might not indicate a pregnancy as early as a blood test in the office, so you'll want to be tested by a medical professional.

The Risks of Pregnancy with an IUD

An IUD pregnancy comes with certain risks and complications. "You're 50 percent more likely to miscarry if the IUD is left in place, so the recommendation is to let the pregnancy continue and remove the IUD," says Dr. Sam. But you're also 25 percent more likely to miscarry even if the IUD is removed, so your doctor will want to monitor any IUD pregnancy closely.

IUD pregnancies also come with a higher risk of ectopic or tubal pregnancy, in which the fertilized egg implants somewhere outside the uterus (usually the fallopian tubes). Ectopic pregnancies almost always end in loss of the pregnancy, and they need to be treated quickly to prevent permanent damage to the woman's reproductive system. Your doctor will diagnose ectopic pregnancy with blood tests, pelvic exams, and ultrasound. If you have one, it will be treated with medication or surgery. 

Getting Pregnant After Removing an IUD

Although becoming pregnant with an IUD is rare, it’s easier to conceive after you remove the device. (That's good news if you want to get pregnant, and fair warning if you don't!) 

If you have decided to try to conceive, give your OB-GYN a call to have your IUD removed, and get busy trying. Some doctors recommend waiting three months to give your body time to bounce back to its usual menstrual cycle. This will help you get a sense of ovulation and fertility cycles. But according to Dr. Perez, there's no medical need to wait: "You can ovulate and get pregnant the next month!”

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