What you need to know about giving up contraception

As tempting as it is to leap straight from contraception to conception, you may want, or need, to wait.

If you are trying to get pregnant, there are some changes you could make to prepare for a new baby. See our checklist to ensure you're doing everything.

Whichever type of contraception you're stopping, it's a good idea to have a general health check-up before you conceive. This way your doctor can review your health and lifestyle and also prescribe suitable supplements.

You'll need to take folic acid as soon as you start trying for a baby.

When should I stop taking the pill?

If you're coming off the combined pill (combined oral contraceptive or COC), it's best to stop taking it when you've finished one complete cycle of pills.

It's usually recommended that you wait until you've had one normal period before you start trying for a baby. This can help calculate your baby's due date, and give you time to be in the best of health. If you do get pregnant before your period, your first ultrasound scan can give you an accurate due date.

Don't worry if you get pregnant immediately after stopping the pill. It won't harm your pregnancy or your baby. This is also true if you get pregnant while still taking the pill.

When should I stop taking the mini pill?

If you're on the mini-pill (progestogen-only pill or POP), you can stop taking it at any time. It's often recommended that you wait until you have at least one normal period before you start trying for a baby. This can help with dating your pregnancy.

There will be no harm to your pregnancy or your baby's health if you get pregnant just after coming off the mini pill. It also won't cause any harm if you get pregnant while you're still taking it.

How soon will I be fertile after my implant is removed?

The progesterone in your implant works by stopping your ovaries from ovulating. It thickens your cervical mucus so that sperm can't swim easily in it. These effects can wear off very quickly. You could become pregnant before you get a normal period.

You will need to visit your doctor to have your implant removed. Your doctor will feel around to locate the implant. Then she'll give you an injection of local anaesthetic, before removing the implant.

How long will a contraceptive injection take to get out of my system?

It depends on which injection you've had. In India, contraceptive injections appear less popular than they are in the west. The most commonly available injections in India are:

• Depo-medroxyprogesterone acetate (DMPA), commonly known as Depo, Depo-Provera, Megestron, and Petogen.
• Norethisterone enanthate (NET-EN) or norethindrone enanthate, commonly marketed as Noristerat and Syngestal.
• Medroxyprogesterone acetate (MPA) or estradiol cypionate, commonly marketed as Cyclofem, Ciclofem, Ciclofemina, Cyclo-provera,Feminena, Lunella, Lunelle, and Novafem among others.

Each Depo-Provera injection gives you 12 weeks' contraceptive cover. Each Noristerat injection lasts for eight weeks. Once this time is up, it may take a little while for you to become fertile, particularly if your injection was Depo-Provera.

With Noristerat, you could start to ovulate again around the time that you'd be due for your next injection. You're unlikely to get pregnant immediately, though.

Depo-Provera can take at least several months to clear your system enough for you to ovulate.

There have been concerns that conceiving while the Depo-Provera hormones were still in your system, could lead to birth defects and low birth weight. Recent studies have not backed this up. There have been no such concerns with Noristerat. All the same, make it a point to discuss any worries or concerns with your doctor.

I've been using a coil. Will it affect my fertility?

Your normal fertility will return as soon as you have your coil or intrauterine device (IUD) taken out. To have it removed, you will need to visit your doctor.

You may be concerned that using an IUD may have increased your risk of pelvic inflammatory disease (PID). PID can lead to fertility problems if left untreated.

It's true that your risk of PID is higher in the few weeks after you've had your IUD fitted.

However, the main risk of PID is from a pre-existing chlamydia or gonorrhea infection. Before inserting an IUD you will be tested and, if necessary, treated for chlamydia. If your doctor thinks there is a chance you may have gonorrhea, you will be tested and treated for this too.

Beyond the first few weeks of having your IUD fitted, your risk of PID is the same as other women not using an IUD. Your risk of PID also depends on your risk of contracting a sexually transmitted infection.

Past chlamydia infection is associated with blockages to the fallopian tubes causing infertility, not past IUD use.

How long will the contraceptive patch take to get out of my system?

It can take a few months for your normal menstrual cycle to return when you stop using the contraceptive patch.

It's probably easiest to stop at the end of a patch cycle. It's usually recommended that you start trying to conceive after you've had one normal period. This makes working out your due date easier. You can also start taking folic acid in good time.

If you stop sooner and get pregnant straight away, no harm will come to your pregnancy or your baby.

I've been using an intrauterine system. Will it affect how soon I conceive?

Your normal fertility will return soon after you've had your intrauterine system (IUS) taken out. It can be taken out at any time, and you can start trying for a baby straight away. To have it removed, you should visit your doctor.

The IUS is similar to the IUD in that it could increase the risk of an infection from bacteria already in your body. This is more likely in the first few weeks after you've had it inserted.

The main risk to your fertility, however, is from a pre-existing chlamydia or gonorrhea infection. Before inserting an IUS you will be tested and, if necessary, treated for chlamydia. If your doctor thinks there is a chance you may have gonorrhea, you will be tested and treated for this too.

After that, it's thought that you have lower risk of infection. This is because the progesterone in your system makes your cervical mucus thicker, stopping infections from getting in. Even so, it's best not to take the risk of contracting a sexually-transmitted infection.

Research has found that past chlamydia infection is associated with blockages to the fallopian tubes causing infertility, not past IUS use.

If I conceive while using a spermicide, will it affect my baby?

If you become pregnant while using a spermicide, either with a diaphragm, cap or condom, there's a very slight chance it may affect your baby. There's thought to be a slightly increased risk of your baby having a heart defect.

The heart defect is a hole between the left and right ventricle, which is treatable. However, we don't know for sure if spermicide causes this defect, or whether it is associated with it for another reason.

Can sterilisation be reversed?

Of all forms of contraception, sterilisation is the hardest to reverse. It is possible to have an operation to try to reverse it.

Reversal can be less successful as you get older. How the sterilisation was done, and the method used to reverse it, can also affect the chances of success. If the sterilisation severely damaged your fallopian tubes, a reversal may not be possible at all.

Other factors that are thought to impact the success of a reversal operation include:

• The remaining length of the tube after recanalisation. Preserving as much tube length as possible during the original sterilisation, is thought to have a positive impact on the success of the operation.
• The woman's age. More women under 30 years of age appear to conceive than those over 30.
• The time interval between sterilisation and reversal.
• The site of ligation.
• The method used for the previous ligation.

If you had a clip sterilisation then the odds are thought to be better. However, the clip sterilisation method does not appear to be frequently used in India. A reversal is a major operation and will involve staying in hospital.

The Federation of Obstetric and Gynaecological Societies of India (FOGSI) recommends using rings (Fallope rings) as a preferred method of blocking tubes (tubal ligation) in India. However cutting the tubes is also acceptable. Your doctor will be able to tell you more about the procedure and how effective a reversal would be in your situation.

If your husband has had a vasectomy this can be reversed too. Success rates vary widely.

Some men develop sperm allergy after a reversal. Their body produces antibodies that kill their own sperm. In which case fertility treatments are needed for their wives to conceive.

यह लेख हिंदी में पढ़ें!

Read more on:

• 10 fun things to do when you are trying to conceive
• Can I get pregnant just after my period?
• How soon can I take a pregnancy test?