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Women can get pregnant soon after stopping taking oral contraceptives.

Must you completely clear your system of birth control pills before getting pregnant?

Oral contraceptives prevent pregnancy by inhibiting ovulation, but are metabolised quickly once stopped. Doctors advise waiting until after the first period before trying to fall pregnant

If you’re taking birth control pills, must you wait for them to be “fully cleared” from your system before you can fall pregnant?

The simple answer: No

If you are taking birth control pills but are contemplating becoming pregnant in the near future, you may wonder how long it’ll take you to conceive after discontinuing use of the pills. After all, it’s a common perception that it takes some time for the hormones in birth control pills to be totally eliminated from your system before you have a chance of falling pregnant.

Obviously, oral contraceptives work only while you take them regularly. According to Dr Ann Tan, a gynaecologist and obstetrician from Women Fertility & Fetal Centre in Singapore, once you stop taking birth control pills, the medication is said to metabolise to half its strength in less than two days, meaning that it should clear out of your system pretty quickly; ovulation should begin again within weeks and your chances of falling pregnant should return to what it was before you started taking the pills.

Oral contraceptive pills.
If you plan to have a baby, Dr Tan says to wait for one proper period before you start trying. She also says it’s important to remember to take prenatal supplements and practise healthy lifestyle habits beforehand, to improve the health of your eggs and reduce the risk of foetal anomalies.

Of course, there are some exceptions, and not all women are lucky enough to fall pregnant as soon as they stop taking oral contraceptives. Dr Tan says that if you have been taking the pills for an extended period of time, say 10 years, then your ovarian function may be quite severely suppressed. In this case, you may not experience regular periods for three to six months, and it may take a few cycles for your ovarian function to return to normal.

“These women are more likely to have had problems such as polycystic ovary syndrome prior to taking birth control pills,” says Dr Tan. “Or they may have developed hypothyroid or other hormonal disorders while on the pill.” She adds that you should ask yourself what your periods were like before taking oral contraceptives. “Were they erratic? If the answer is yes, then you may have problems conceiving so soon after stopping oral contraceptives.”

Dr Ann Tan, a gynaecologist and obstetrician at Women Fertility & Fetal Centre in Singapore.
There are also other factors that can influence your fertility after you stop taking oral contraceptives. Your age is one. For example, if you were 25 when you first started taking birth control pills and are now in your mid- or late 30s, your chances of falling pregnant within your first year of trying will have dropped. Your overall health is also important in determining how soon you will conceive after discontinuing your oral contraceptives. If you were healthy prior to going on the pill but are now experiencing problems that may be affecting your reproductive health and fertility, then you may find that you cannot get pregnant right away.

If you aren’t sure about your chances of conceiving, Dr Tan says that there is a test to determine your hormone levels, the health of your ovaries, and so on. The test should give you an idea of your fertility once you stop taking birth control pills.

Once you start coming off oral contraceptives, ovulation can be delayed so you may wish to use condoms until you have had one or two periods. That way, you can keep track of your cycle so that you can estimate a due date when you do become pregnant.

This article appeared in the South China Morning Post print edition as: Off the pill? Falling pregnant fast is not inconceivable
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