Coming off the pill to get pregnant: what really happens

This is one of the most common misunderstandings in contraception. The belief is that you must come off the pill months before you want to conceive, to let the hormones "wash out" and your fertility "return to normal". It is not true, and believing it can cause real heartache.

Your fertility comes back straight away

Stopping the pill is simply a long version of the hormone-free week. Once the hormones are gone, your ovaries wake up, usually within a couple of weeks, often in the very first cycle. There is nothing to flush out and nothing to wait for. Studies that follow women after they stop the pill find that the chance of being pregnant within a year, between roughly 72 and 94 percent, is the same as for women who stopped condoms or a coil, or who used no hormones at all. And it makes no difference how long you were on the pill; years of use do not slow your return to fertility, and if anything may slightly help it.

Why this matters, in both directions

It cuts two ways, and I have seen both in clinic. If you are not ready to be pregnant, do not assume there is a grace period after stopping; there is not, so use another method from the day you stop. And if you are planning a pregnancy, you do not need to come off months early "to be safe". You can start trying as soon as you stop. I have sat with too many people in tears because they fell pregnant the first month, having been told it would take half a year.

If it does take time, the pill is not the reason

Some couples take a while to conceive, and that is completely normal: about four in five are pregnant within a year, and the rest simply take a little longer. If that is you, please do not blame yourself, and please do not blame your pill, because it is not the cause. It is striking how quickly the finger gets pointed at a woman and her contraception, when in about half of couples who struggle there is a male factor, and sperm counts across the world have fallen markedly over recent decades. Age plays its part too, for both of you. Your years on the pill simply do not.

If you are thinking ahead

If you are planning a pregnancy, or wondering when to stop, talk to us. We can go through timing, folic acid and anything in your health worth sorting first, and we can look into things sensibly if conception is taking longer than you hoped, for both partners.