It is common for women to ask, “Can you get pregnant with an IUD?” The simple answer is yes, it is possible.

It is essential to understand how IUD birth control works. There are two types of IUDs:

• Hormonal

• Copper

A hormonal IUD works in much the same way birth control pills or injections do. It releases hormones that help prevent ovulation or an egg from entering the fallopian tubes to travel to the uterus for fertilization. If no egg drops, there can be no pregnancy.

A copper IUD does not use hormones or affect ovulation. Instead, the copper on the device serves as a spermicide. This keeps sperm from entering the uterus, where there might be an egg. For contraception to occur, sperm must fertilize an egg. If the sperm doesn’t travel to the egg, fertilization can’t happen.

Both hormonal and copper IUDs are effective forms of contraception. Both can also fail, leading to pregnancy.

There are a few possibilities, including:

• Expulsion – The American College of Obstetricians and Gynecologists (ACOG) reports the expulsion rate for IUDs is 2 - 10% in the first year.

• Shifting – The device can shift to a place where it is less effective.

• Old device – IUDs do have expiration dates. If yours is older, it may fail to work.

There is also a possibility you were already pregnant at IUD insertion or contraception happened shortly afterward. That is less of a concern with a copper IUD. They are effective immediately and even work as emergency birth control. The device should prevent pregnancy from sex up to seven days before insertion.

How Do You Know If You Are Pregnant?

If you suspect you are pregnant even after IUD insertion, you may be experiencing symptoms such as:

• Sore or swollen breasts

• Feeling nauseous

• Having to pee more frequently

• Fatigue

A copper IUD will not affect your periods, either. So, if you are late, it may indicate pregnancy. If the pregnancy is ectopic, you may also experience vaginal bleeding and pain. The bleeding may present as a brown, watery discharge.

When to See Your Doctor

The first step is to see your doctor for several reasons.

To Confirm Pregnancy

This allows you to confirm your pregnancy and to document the type. Even if you have taken a home pregnancy test, it is vital to get medical confirmation.

There are two primary forms of pregnancy:

• Intrauterine

• Ectopic

Intrauterine means the egg is in the uterus, which is normal. Ectopic refers to a fertilized egg growing outside the womb, usually in the fallopian tubes. This is a dangerous condition because an egg outside the womb cannot develop normally and may lead to heavy and possibly life-threatening bleeding.

Find Out If the IUD is Still in Place

This will also allow the doctor to see if the IUD is still in place. They can come out without you realizing it. If that happens, you would have no form of birth control. That would explain the pregnancy.

 IUD Removal

If the IUD is in place, the doctor will probably want to remove it. While it is physically possible to continue your pregnancy and give birth with an IUD, it is not recommended. Studies indicate a number of potential complications, such as:

• Pre-term delivery

• Bacterial infection

• Low birth weight

• Miscarriage

Your healthcare provider will check to see if the IUD strings are accessible. In some cases, the strings may curl up into the cervix. It may still be possible to remove the IUD, depending on the stage of the pregnancy. The uterus expands as the fetus grows. That may mean the IUD is unreachable unless it is still an early pregnancy.

If your doctor cannot reach the IUD, they may order ultrasound imaging to find it. Depending on its location, it may be safer to leave it in place until after you give birth if you continue the pregnancy.

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