Pregnant With an IUD?

How to Manage an IUD Pregnancy

IUD Pregnancy
Risks of IUD Pregnancy. Photo © Dawn Stacey

It is very uncommon to become pregnant when you have an IUD. But even though it is rare, it can happen. isn't common, but it can happen. So if this is your situation, find out more about managing the pregnancy risks and complications associated with an IUD pregnancy.

What is an IUD and How Common Do You Even Get Pregnant with an IUD?

An IUD (intrauterine device) is a small, flexible birth control device that is shaped like the letter T and is inserted into your uterus.

This contraceptive method is long-lasting, safe, and extremely effective. There are four IUD types available:

  • Mirena IUD: Made of a soft, flexible plastic, Mirena releases a low amount of the progestin levonorgestrel continuously over a 5-year period as one way to prevent pregnancy.
  • Skyla IUD: Mirena's "little sister"—releases a low amount of the progestin levonorgestrel over a 3-year period as one way to prevent pregnancy.
  • Kyleena IUD: Works the same way as both Mirena and Skyla; lasts for 5 years, is about the same size as Skyla, contains more progestin than Skyla but less than Mirena.
  • ParaGard IUD: Also called the Copper T 380A, it is made of flexible plastic and wrapped in copper. Unlike Mirena, Skyla, and Kyleena, it is hormone-free. ParaGard releases a tiny amount of copper over a 10-year period as one way to prevent pregnancy.

IUDs are one of the most effective reversible methods of birth control available.

The hormonal IUDs are 99.1-99.9 percent effective, while ParaGard is 99.2-99.4 percent effective. Meaning... that out of every 100 women who these IUDs in one year, less than one will become pregnant with typical use as well as with perfect use. Although these numbers are very promising, IUDs are not foolproof.

This means that less than 1 percent of the time, a woman will become pregnant with an IUD. So, yes, an IUD pregnancy is possible.

I Think I've Become Pregnant with My IUD

If you believe that you are experiencing an IUD pregnancy, the first thing you should do is confirm that you are pregnant. You can take a home pregnancy test or schedule a blood pregnancy test with your doctor. If you have indeed become pregnant while your IUD is still in place, your doctor will most likely recommend that your IUD be removed. You may decide that you want to continue with your pregnancy with your IUD in place. If so, your doctor will want to monitor your IUD pregnancy closely. That being said, there are several reasons why it is healthier and safer to have the IUD removed.

Miscarriage and IUD Pregnancy

Women who have become pregnant with an IUD are more likely to miscarry than women who did not have an IUD in place when conceiving. In a non-IUD pregnancy, the miscarriage rate is about 18-20 percent. If you choose to leave the your IUD inserted during your pregnancy, your miscarriage rate increases to about 50 percent.

Removing your IUD early in a pregnancy reduces the risk of miscarriage to around 25 percent.

But, it is important to point out that the process of removing your IUD can also cause a miscarriage—though your risk of miscarriage is lower if you have your IUD removed as soon as your pregnancy is confirmed, the risk is still higher than that of women without an IUD. Ask your doctor about these risks, so you can make an informed decision about how to continue with your IUD pregnancy.

IUD Pregnancy and Preterm Birth

Leaving an IUD in place during your pregnancy increases the likelihood of preterm delivery. Women who have IUDs in place during their pregnancies are up to four times more likely to deliver their baby prematurely than women without an IUD in place. Also, if you have become pregnant with a hormonal IUD (Mirena, Skyla, or Kyleena), your IUD is slowly releasing progestin into your uterus. If you decide to continue with your pregnancy with one of these IUDs in place, the long-term effects of the hormone on the baby are not clearly known.

Ectopic IUD Pregnancy

The use of IUDs is considered to be a risk factor for a future ectopic pregnancy (a pregnancy where the egg implants outside of the uterus). In the general population, ectopic pregnancies occur about 2 percent of the time. But, if you become pregnant while your IUD is in place, your risk of having an ectopic pregnancy is higher. That risk ranges from 6 percent to as high as 50 percent.

IUD Pregnancy and Infection

There is always the possibly that an infection can occur in women who have IUDs. Women who choose to keep their IUDs intact during pregnancy may increase their chance of intrauterine infection, sepsis, and septic second-trimester fetal loss. Sepsis is a potentially dangerous or life-threatening medical condition—the majority of sepsis cases are due to bacterial infections.

Women who become pregnant with an IUD in place and choose not to remove it during the first trimester of their pregnancy are at a greater risk of septic second-trimester fetal loss (miscarriage). Many of these septic losses are particularly unpleasant and, in some cases, can be associated with subsequent infertility.

Finally, though extremely rare, maternal deaths have been reported during the second trimester of pregnancy due to infection when an IUD has not been removed during the pregnancy.

A Word From Verywell

Learning about the possible risks and complications associated with an IUD pregnancy can be overwhelming and scary. Some women decide to keep their IUDs intact and have completely successful pregnancies. Unfortunately, the potential complications of continuing with your IUD pregnancy are serious and real. Do your research and have an honest conversation with your doctor about the best way of managing your pregnancy. If it makes you feel more confident in making a decision, seek out a second opinion. Becoming more educated about these risks can help you feel more in control when it comes to managing and making decisions about your IUD pregnancy.

 

Sources:

Foreman H., Stadel B., Schlesselman S. "Intrauterine device usage and fetal loss." Obstetrics & Gynecology. 1981;58(6):669-677. 

Ganer H, Levy A, Ohel I, Sheiner E. "Pregnancy outcome in women with an intrauterine contraceptive device." American Journal of Obstetrics and Gynecology. 2009;201(4):381.e1–381.e5.

Grimes DA. "Intrauterine devices (IUDs)." Contraceptive Technology 19 (2004):117-43.

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