Miscarriage Risk if Pregnancy Occurs While Using an IUD

Learn Whether You're at Higher Risk For Pregnancy Loss

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An intrauterine device (IUD) is a common form of long-term contraception that involves a plastic or copper device being placed in the uterus to hinder the passage of sperm through it. Although IUDs are one of the most effective forms of reversible birth control on the market, about 1 in 200 women with an IUD will become pregnant each year.

Some of those pregnancies will be ectopic (that's when the fertilized egg implants somewhere other than in the uterus, usually in the fallopian tubes).

Any ectopic pregnancy must be terminated, but any non-ectopic pregnancy that is conceived with an IUD in place may be continued if the mother wants to try to keep the baby.

But what's the risk of miscarriage if you get pregnant with an IUD in place?

IUD Failure and Risk of Miscarriage

Here is what UpToDate, an online reference site for doctors and patients, has to say about the odds of miscarriage in pregnancy with a failed IUD. Note than an IUC is the same thing as an IUD:

"The risk of pregnancy is highest in the first year after IUC (intrauterine contraception) insertion. Among women who conceive with an IUC in situ, the [miscarriage] rate is 40 to 50 percent, a rate more than two-fold higher than that of the general obstetric population. A retained IUC also increases the risk of several late gestational adverse maternal and neonatal outcomes; this risk is reduced, but not eliminated, with early removal of the IUC."

So, in other words, there's, unfortunately, a higher than average chance of miscarriage in a non-ectopic pregnancy that is conceived with an IUD in place. But here's another way to look at it: There's an equal to slightly higher chance that the mother will not miscarry.

Other IUD Pregnancy Risks

There's also an increased risk of other problems in later pregnancy, but removing the IUD in early pregnancy reduces those risks.

Considering the benefits of early IUD removal, along with the need to screen for ectopic pregnancy, it's wise to contact your doctor at once if you discover that you're pregnant while using an IUD.

More questions? Read on.

Isn't there a strong chance that the pregnancy would be ectopic?
It is true that the risk of ectopic pregnancy is higher if you get pregnant with an IUD in place. 

How is the IUD removed?
The doctor may carefully remove the IUD by pulling on the strings if they are visible. If the strings are not visible, the doctor may attempt to locate the IUD by ultrasound and remove it with ultrasound guidance, if it seems like it would be safe to do so.

Couldn't the IUD removal process hurt the baby?
In some cases, it can, which is why you should talk to your doctor. Don't attempt to pull on the strings to remove the IUD yourself.

Can a pregnancy be continued with an IUD in place?
Sometimes, a doctor may advise against IUD removal. An example of such a case would be if the IUD appears to be embedded in the placenta. In these cases, the pregnancy may be continued with the IUD in place, but there's a higher risk of later pregnancy complications (such as premature birth) than in cases where it is possible to safely remove the IUD.

In any case, your doctor will advise you on the best course of action after examining you.

Want to learn more? See UpToDate's topic, "Management of problems related to intrauterine contraception," for additional in-depth medical information.


Dean, Gillian and Alesa B. Goldberg. "Management of problems related to intrauterine contraception." UpToDate. Accessed: May 2010.

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