Can you get Pregnant if you have an IUD?

Ruth Mielke, DNP, RN, CNM • March 6, 2023

Pregnancy With an IUD

An intrauterine device (IUD) is a small T-shaped device inserted into your uterus to prevent pregnancy. It is considered a long-term but reversible form of contraception. It is one of the most effective and popular forms of birth control available.

There are two types of IUDs.

Copper: makes the uterus inhospitable to sperm. (Brand name: ParaGard)
Hormonal: Releases a progesterone-like hormone called progestin which prevents the ovaries from releasing eggs (Brand names: Kyleena, Liletta, Mirena, and Skyla)

All IUDs are more than 99% effective, but none are 100%.

This article will discuss how you can get pregnant while you have an IUD, what to do if you think you are pregnant and have an IUD, the risks associated with pregnancy with an IUD for both the woman and the fetus, and options to consider.

How Can You Get Pregnant With an IUD?

There are several possible ways pregnancy can occur after you have an IUD inserted:

Your IUD can become displaced or fall out after insertion. This is more common if the IUD is placed after a vaginal delivery or an abortion and usually occurs within three months. You can get pregnant if you are unaware the IUD is no longer in place.
You can get pregnant if you have intercourse within seven days of having a hormonal IUD placed. Hormonal IUDs can take up to seven days to be effective, depending on when in your menstrual cycle the IUD is placed. It is effective immediately if placed while you are on your period.
You can become pregnant if your IUD has been in place longer than recommended and has expired. It is essential to know the expiration date of your IUD.

What should You do if you have an IUD and Suspect You are Pregnant?

If you are concerned your IUD has failed, talk to your healthcare provider about using emergency contraception (EC). Emergency contraception can prevent pregnancy if you discover your IUD is not in place within a few days of having intercourse.

You may notice typical signs of pregnancy if you become pregnant with an IUD. Some of these symptoms can be similar to side effects from your IUD, which can be confusing. These signs include:

Missed period (you may not have a period if you have a hormonal IUD)
Nausea with or without vomiting
Sore and enlarged breasts
Mild cramping
Mild spotting
Fatigue
Increased urination
Food aversions

You can take a home pregnancy test if you suspect you are pregnant. These tests are about 99% accurate. If you have periods with your IUD, you can take the test on the first day of your missed period. If your IUD causes irregular periods, wait a week or two to take a test.

If you have unusual symptoms, talk to a healthcare provider. They can confirm if your IUD is still in place and verify if you are pregnant or not with a urine or blood test.

What are the Risks with Pregnancy and an IUD?

IUD pregnancies are more likely to be ectopic or occur outside the uterus.

Most commonly, ectopic pregnancies occur in the fallopian tubes. The tubes can burst and cause life-threatening bleeding. The pregnancy will not develop past a few weeks. Symptoms of an ectopic pregnancy include:

Sharp pain in your abdomen, pelvis, shoulder, or neck
Severe pain on one side of your abdomen
Vaginal bleeding
Dizziness
Fainting
Rectal pain or pressure

An ectopic pregnancy is an emergency. If you are concerned about having an ectopic pregnancy, seek medical attention immediately.

If you are pregnant and have an IUD, you are at high risk for adverse pregnancy outcomes, such as:

miscarriage, also known as spontaneous abortion
preterm rupture of the amniotic sac
preterm delivery due to infection
placental abruption, when the placenta pulls away from the uterus before the baby is born

For your baby, giving birth with an IUD in place is associated with higher neonatal intensive care unit (NICU) admission rates and more severe illnesses such as infections.

What are my options?

There are two main options if you become pregnant with an IUD – continue your pregnancy or terminate the pregnancy. If it is ectopic, termination is necessary because the embryo cannot survive outside the uterus, and you have a significant risk of bleeding and even death.

If you continue your pregnancy, the recommendation is to remove your IUD. There are significant improvements in pregnancy outcomes after removing an IUD in early pregnancy versus leaving it in the uterus.

If your healthcare provider can see and grasp the strings of your IUD, they will gently remove it. If they cannot see the strings, you may need an ultrasound to find your IUD. If the IUD is above the cervix, your provider may remove it using a special scope that looks inside your uterus.

Removing the IUD reduces the risk of pregnancy complications. The IUD needs to be removed during the first trimester. Even when your IUD is removed, your pregnancy is at high risk, but removing the IUD lowers your risk.

If you choose termination, also known as abortion, your doctor will remove your IUD at the same time. Different termination methods are used depending on how far along your pregnancy is. Your provider will go over your options with you.

Summary

IUDs are an effective and safe form of contraception. But like every method of contraception, they can fail.

The earlier pregnancy with an IUD is identified, the better your chances of being able to continue your pregnancy if you desire.

Knowing the signs of pregnancy and when to contact your healthcare provider is essential.

Sources:

https://www.plannedparenthood.org/learn/birth-control/iud

https://www.ncbi.nlm.nih.gov/books/NBK557403/\

https://health.ucsd.edu/news/features/Pages/2020-01-15-personalizing-iud-choice.aspx#:~:text=There%20are%20four%20leading%20types,environment%20not%20suitable%20for%20sperm.

https://my.clevelandclinic.org/health/treatments/24441-intrauterine-device-iud

https://www.mayoclinic.org/healthy-lifestyle/getting-pregnant/in-depth/symptoms-of-pregnancy/art-20043853

https://www.womenshealth.gov/a-z-topics/pregnancy-tests

https://www.mayoclinic.org/diseases-conditions/ectopic-pregnancy/symptoms-causes/syc-20372088#:~:text=Often%2C%20the%20first%20warning%20signs,and%20which%20nerves%20are%20irritated.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3418877/#:~:text=Compelling%20evidence%20has%20demonstrated%20that,in%20such%20cases%20%5B18%5D.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3418877/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5893319/[KVW18]

Author Bio:

Ruth Mielke is a certified nurse midwife and RN with over two decades of clinical experience. She has a Doctorate in Nursing Practice. Ruth is expanding her career to include freelance health and wellness writing.

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Thank you for reading Patient Education Essentials, the Write Shift RN blog.

Disclaimer: This article was written as a guest post for Write Shift RN LLC's blog. The information in it may not be wholly fact-checked or edited, allowing the reader to see the writer's work and skills firsthand. This information is not intended as medical advice. It is for informational and educational purposes only. Always talk to your doctor or other qualified healthcare providers about any questions or concerns you may have regarding medical conditions.

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Steroid Injections vs. PRP

By Kristina Van Winkle • October 7, 2024

A Comparative Overview for Pain Management Steroid injections and Platelet-Rich Plasma (PRP) injections are two commonly used pain management treatments. While both aim to alleviate pain and promote healing, they have different mechanisms of action and long-term effects . What Are Steroid Injections ? Corticosteroids are potent drugs used extensively across various medical fields to manage a broad spectrum of conditions, making them one of the most widely prescribed drug classes in the world. They can be administered via nearly every route, including direct injection into painful or inflamed joints. "Corticosteroids" typically refers to the class of drugs that produce glucocorticoid effects. Glucocorticoids are stress hormones that regulate numerous physiologic processes within the body. They have vasoconstrictive, immunosuppressive, and anti-inflammatory effects and play a role in metabolism. What do steroid injections treat? Corticosteroids function by suppressing the immune system and reducing inflammation within the body. They inhibit the production of the body's pro-inflammatory chemicals, leading to decreased inflammation and, consequently, pain. They are prescribed for hundreds of medical conditions, including: Allergic and autoimmune disorders Adrenocortical secretion disorders Infections and inflammation Pathologic hypoglycemia Organ and graft rejections Neurological disorders Hypercalcemia Blood disorders Skin disorders Shock What are the side effects of steroid injections? Although steroids are known to some as “wonder drugs,” they impact various bodily systems, including metabolism, water and electrolyte balance, the central nervous system, and blood cells. As a result, they are associated with many adverse side effects, especially when administered in large doses or over extended periods. Adverse effects may occur in up to 90% of individuals who take them for longer than sixty days. These side effects may include: Suppression of the hypothalamic-pituitary-adrenal axis Gastrointestinal disturbances Osteoporosis and fractures Psychiatric disturbances Carpal tunnel syndrome Cardiovascular disease Immunosuppression Cushingoid features Hyperglycemia Skin disorders Glaucoma Myopathy Cataracts Diabetes The risk of adverse side effects is particularly high when taken systemically. However, side effect occurrences vary when administered as local injections for pain management. Data indicates that steroid injections into joints and the spine can produce systemic effects that can last for weeks. When assessing the risk factors associated with steroid injections, healthcare providers must consider all types and doses of steroids the person is taking, including both oral and injectable forms. Additionally, special caution is advised for certain populations, such as those who may undergo surgery soon, postmenopausal women, and individuals with diabetes. What is Platelet-Rich Plasma (PRP) ? Platelet-rich plasma (PRP) injections use an individual's own blood to promote cellular regeneration. Through the extraction and reinjection of platelets, growth factors, and other bioactive proteins from the person's blood, PRP therapy offers long-lasting improvements, sustained pain relief, and enhanced tissue function. What do PRP injections treat? PRP injections can stimulate healthy cell growth, reduce inflammation, promote tissue repair, form new blood vessels, rejuvenate the skin and hair, and accelerate recovery after a traumatic injury. It can treat a wide range of conditions, including: Pain resulting from traumatic injury or degenerative conditions such as arthritis and chronic back pain Musculoskeletal conditions Tendinopathies and tears Compressive neuropathy Scars and stretch marks Osteochondral lesions Rheumatoid arthritis Erectile dysfunction Muscular injuries Plantar fasciitis Vaginal atrophy Osteoarthritis Epicondylitis Infertility Psoriasis Wounds Bursitis Vitiligo What are the side effects of PRP? Since PRP is derived from the person's own blood, the risk of allergic reactions or rejection is significantly lower compared to other injectables, such as steroids. PRP typically does not cause major side effects, though you may experience some soreness or bruising at the injection site. In rare cases, potential side effects may include: Tissue damage Nerve injuries Bleeding Infection Comparison of Steroid Injections and PRP Injections A study in the Journal of Orthopaedic Surgery and Research compared steroid injections with PRP injections in patients with mild to moderate symptomatic knee osteoarthritis (OA). The findings indicated that both treatments were safe and effective in improving short-term pain and functioning, with no significant differences observed. However, PRP therapy demonstrated superior outcomes in the long term, with benefits extending up to one year. Additionally, a literature review in Cureus Journal of Medical Science analyzed multiple studies comparing steroid injections with PRP in lumbar spondylosis and sacroiliac arthropathy. The review found that PRP was equally as effective, if not superior, to steroid injections in the short term. Neither treatment was associated with major complications, and there were no significant differences in minor complications between the two. The review concluded that both PRP and steroid injections are safe and effective for treating lumbar spondylosis and sacroiliac arthropathy, with some evidence that PRP may offer more benefits in the long term. Research has confirmed that both steroid and PRP therapy are valuable options for pain management and tissue healing. Steroid injections offer potent anti-inflammatory benefits that can provide immediate relief. However, their systemic side effects and limited duration of efficacy should be carefully considered, especially in high-risk populations. While PRP may take longer to show results, its long-term benefits make it an increasingly popular choice for treating various conditions. Ultimately, the choice between these treatments should be based on the specific needs of the individual patient, with careful attention to the patient's medical history. Thank you for reading the Write Shift RN blog. If you need an experienced RN writer for your health or healthcare educational content, contact me !