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Getting Pregnant and Infertility After Depo-Provera

Depo-Provera, often known as the contraception shot, can utterly cease your menstrual cycles, particularly with repeated use. This may be worrisome in case you’re not anticipating it, and you might fear about whether or not and when your cycles will come again. Depo-Provera has a poor popularity on-line and in fertility boards. Earlier customers are sometimes shocked by how lengthy it takes for his or her fertility to return after discontinuing the injections.

You probably have stopped utilizing Depo-Provera and need to get pregnant, you could have issues and questions. For instance, when will you be capable to get pregnant once more? Is it regular to take so lengthy to your fertility to return? Can Depo-Provera trigger long-term infertility? Study extra about getting pregnant after Depo-Provera.

What Is Depo-Provera and How Does It Work?

Depo-Provera is the model title for depot medroxyprogesterone acetate (DMPA), progestin-based contraceptive injection. It really works by suppressing ovulation and thickening cervical mucus and gives three months of dependable contraception. Injections are repeated each three months for so long as contraception is desired.

Not like contraception capsules, which have to be taken each day, Depo-Provera solely must be taken as soon as each 90 days. It is because the injection creates a depot (or storage) of medroxyprogesterone acetate within the physique on the website of the injection.

After the injection, progesterone ranges within the physique step by step rise for about three weeks. After three weeks, it reaches its peak. Then, the degrees of progesterone slowly decline. When progesterone ranges are beneath a sure degree (lower than 0.1 nanograms per milliliter), ovulation and common menstruation start once more.

Amenorrhea (lack of menstrual durations) is a standard aspect impact of Depo-Provera. After about one 12 months (or 4 injections) of taking Depo-Provera, 50% of ladies cease having their menstrual durations. This isn’t an indication of infertility. Often, your interval will return inside 6 months of the final injection, however it might take longer.

Getting Pregnant After Depo

So long as you need to stop being pregnant, it’s worthwhile to obtain an injection each 90 days. It is because, after 90 days, the degrees of Depo-Provera will not be excessive sufficient for most girls to reliably stop being pregnant.

Let’s say you need to get pregnant and also you discontinue injections. You may assume your fertility will return on day 91, however this isn’t how the remedy works. Whereas the degrees of Depo-Provera after 90 days might not be excessive sufficient to be thought-about efficient for being pregnant prevention, they could nonetheless be too excessive to get pregnant.

Some ladies will get pregnant the very first month after the 90 days, however this isn’t frequent. Most girls will see their fertility return inside 5 to 7 months of their final injection. In different phrases, about two months after that 90-day interval ends.

Inside 10 months of the final injection, 50% of ladies who discontinue Depo-Provera will get pregnant.

Ovulation After Depo

There are 3 ways to know in case your fertility has lastly returned after stopping Depo-Provera: having a daily menstrual cycle once more, getting optimistic outcomes on an ovulation predictor take a look at, and having ovulation detected on a basal physique temperature chart. In fact, this assumes there are not any extra fertility issues.

Common Menstrual Cycle Returns

Having a daily menstrual cycle is the obvious signal that ovulation has began. Your menstrual cycle lasts from the primary day of your interval to the primary day of your subsequent interval. Your cycles are thought-about common or regular once they meet the next circumstances:

  • Period: Your durations final 8 days or fewer
  • Circulate quantity: You lose between 2 to three tablespoons of menstrual fluid throughout every interval. Simply recognizing might be an indication that you simply’re not ovulating. 
  • Frequency: Your durations sometimes come each 24 to 38 days (the common is 28 days). Because of this from the primary day of your final interval as much as the beginning of your subsequent interval is at the very least 24 days however not more than 38 days.
  • Regularity: Your cycles are constant from month to month. For instance, your cycle is 27 days lengthy one month, and 29 the following. Cycles that fluctuate in size by greater than 7 to 9 days (for instance, a cycle that’s 26 days lengthy one month and 45 the following) are thought-about irregular.

Check Optimistic on an Ovulation Predictor Check

These are ovulation take a look at kits you should buy in any pharmacy or on-line. They work lots like a being pregnant take a look at, in that you simply use your urine to check your hormones. Whereas being pregnant assessments search for hCG, an ovulation predictor take a look at appears for the hormone luteinizing hormone (LH). LH spikes simply earlier than you ovulate.

Ovulation Detected Utilizing a BBT Chart

Your basal physique temperature (BBT) is your physique’s temperature at full relaxation. This temperature adjustments relying on the place you might be in your cycle. If you happen to’re ovulating, your BBT will bounce up and stay larger till you get your interval. Then, it can drop again down and keep there till ovulation happens once more.

You possibly can monitor your BBT at dwelling. This can be a strategy to know if ovulation has returned after Depo-Provera, and it will possibly assist your physician provide help to in case you discover that ovulation has not returned as anticipated.

Short-term Infertility After Depo

However not each lady will get their cycle again 5 months after the final injection. In some circumstances, it might take as much as 22 months—or virtually two years—for fertility to return after the final injection. Why does this occur?

In response to the analysis, the delay appears to be associated to a lady’s weight. Girls who weigh much less could have their fertility return quicker than ladies who are inclined to weigh extra. This has to do with how lengthy it takes your physique to utterly metabolize the progestin.

How lengthy you’ve used Depo-Provera is not related to an extended interval of lack of ovulation. In different phrases, whether or not you used Depo-Provera injections for six months or two years doesn’t matter. Your fertility will possible take the identical period of time to return in both case.

If you happen to acquired the subcutaneous model of Depo-Provera (versus the older extra generally used intramuscular injection), your danger for experiencing a scarcity of ovulation for as much as two years is considerably much less. In response to at the very least one research, 97% of ladies who acquired the subcutaneous model of Depo-Provera had ovulation return after 12 months.

Deciphering Discussion board Posts About Depo

An important factor to know is that Depo-Provera is just not identified to extend your danger of infertility after that these 12 to 22 months. In different phrases, Depo-Provera use is just not related to an elevated danger of infertility basically.

Ovulation (and probably your menstrual cycles) take some time to return as a consequence of your physique not but metabolizing the remedy utterly. Not as a result of Depo-Provera has one way or the other prompted a long-term infertility drawback.

With that mentioned, in nearly each thread about Depo-Provera on infertility boards, you’ll discover ladies saying their fertility by no means returned, even after 2 years. Generally, they’ll assume that this was brought on by the shot. This isn’t backed up by the analysis.

Keep in mind that infertility happens in 1 in 8 {couples}. This consists of {couples} who select to make use of Depo-Provera. There shall be ladies who can’t conceive after Depo, even two years after Depo, however this isn’t as a result of contraception shot. They’d have struggled to conceive with out Depo-Provera as effectively.

When to See Your Physician

In case your cycles will not be coming again otherwise you’re not ovulating, and it’s inside two years of your final shot, there may be sadly little or no your physician can do to assist. You simply want to attend. Which could be extraordinarily irritating.

You must see your physician if:

  • It has been 24 months since your final injection and you might be nonetheless not ovulating
  • Your cycles are irregular two years after your final injection
  • You don’t conceive inside 12 months of ovulation returning (or 6 months in case you’re age 35 or older)
  • You’ve got different danger elements or indicators of a doable fertility drawback

A Phrase From Verywell

Hopefully, your fertility will come again inside three or six months after your final shot. That is the way it ought to work, and many ladies do get pregnant inside 8 to 10 months of their final Depo-Provera shot. Nonetheless, in some circumstances, it will possibly take longer. If you happen to battle to conceive after stopping Depo-Provera, speak to your physician.

Verywell Household makes use of solely high-quality sources, together with peer-reviewed research, to assist the info inside our articles. Learn our editorial course of to be taught extra about how we fact-check and hold our content material correct, dependable, and reliable.
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  5. American School of Obstetricians and Gynecologists. Choices for prevention and administration of heavy menstrual bleeding in adolescent sufferers present process most cancers therapy. Committee opinion no. 606. Obstet Gynecol. 2014;124:397-402.

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  7. Owen M. Physiological indicators of ovulation and fertility readily observable by ladies. The Linacre Quarterly. 2013 Feb 1;80(1):17-23. doi:10.1179/0024363912Z.0000000005

  8. Vigil P, Lyon C, Flores B, Rioseco H, Serrano F. Ovulation, an indication of well being. The Linacre Quarterly. 2017 Oct 2;84(4):343-55. doi:10.1080/00243639.2017.1394053

  9. Leiva R, Burhan U, Kyrillos E, Fehring R, McLaren R, Dalzell C, Tanguay E. Use of ovulation predictor kits as adjuncts when utilizing fertility consciousness strategies (FAMs): a pilot research. The Journal of the American Board of Household Drugs. 2014 Could 1;27(3):427-9. doi:10.3122/jabfm.2014.03.130255

  10. Pallone SR, Bergus GR. Fertility awareness-based strategies: another choice for household planning. The Journal of the American Board of Household Drugs. 2009 Mar 1;22(2):147-57. doi:10.3122/jabfm.2009.02.080038

  11. DEPO-PROVERA CI (medroxyprogesterone acetate injectable suspension, for intramuscular use [package insert]. New York, NY. Pharmacia & Upjohn Firm Division of Pfizer, Inc.

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  13. Datta J, Palmer MJ, Tanton C, Gibson LJ, Jones KG, Macdowall W, Glasier A, Sonnenberg P, Discipline N, Mercer CH, Johnson AM. Prevalence of infertility and assist looking for amongst 15 000 ladies and men. Human Replica. 2016 Aug 19;31(9):2108-18. doi:10.1093/humrep/dew123


Further Studying

  • Kaunitz, Andrew M MD; Zieman, Mimi MD. Depot medroxyprogesterone acetate for contraception. UptoDate.com. 


By Rachel Gurevich, RN

Rachel Gurevich is a fertility advocate, writer, and recipient of The Hope Award for Achievement, from Resolve: The Nationwide Infertility Affiliation. She is knowledgeable member of the Affiliation of Well being Care Journalists and has been writing about ladies’s well being since 2001. Rachel makes use of her personal experiences with infertility to jot down compassionate, sensible, and supportive articles.

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