When Will You Get Pregnant After Depo-Provera?

When Your Fertility Should Return After the Birth Control Shot

Woman's arm with injection needle just beside the arm
Depo-Provera should not be used in women who may want to get pregnant within the next two years.. Image Source / Getty Images

Depo-Provera, also known as the birth control shot, has a poor reputation online and in fertility forums. Previous users are often surprised how long it takes for their fertility to return after discontinuing the injections.

Depo-Provera can also completely stop your menstrual cycles, especially with repeated use. This can be worrisome if you’re not expecting it, and you may worry about whether and when your cycles will come back.

If you have stopped using Depo-Provera and want to get pregnant, you may have concerns and questions.

When will you be able to get pregnant again? Is it normal to take so long for your fertility to return? Can Depo-Provera cause long-term infertility?

The quick answers to these questions are...

  • Many women (50%, according to the research) will be pregnant 10 months after their last Depo-Provera injection.
  • However, for others, it may take up to two years for their fertility to return.
  • After one year of injections, the average length of time for menstrual cycles to return is about 6 months (after the last injection.) This can be longer or shorter.
  • Depo-Provera use is not associated with long-term infertility beyond two years after the last injection.
  • Women who are still not ovulating 22 months after their last injection – or who are not pregnant within 6 to 12 months after they start ovulating – should see their doctor for a fertility evaluation.

    For more detailed answers, keep reading.

    What Is Depo-Provera and How Does It Work?

    Depo-Provera is the brand name for the medication depot medroxyprogesterone acetate (DMPA). It is taken via injection and provides three months of reliable birth control. Injections are repeated every three months for as long as the birth control is desired.

    Depo-Provera is a progestin-based contraceptive. It works by suppressing ovulation and thickening cervical mucus.

    Unlike birth control pills, which need to be taken daily, Depo-Provera injections are needed only once every 90 days. This is because the injection creates a depot (or storage) of medroxyprogesterone acetate in the body at the site of the injection.

    After the injection, progesterone levels in the body gradually rise for about three weeks. After three weeks, it reaches its peak. Then, the levels of progesterone slowly decline.

    Whenever progesterone levels are below a certain level (less than 0.1 ng/mL), ovulation (and regular menstruation) begins again.

    Some women will have their menstrual cycles completely stop while getting Depo-Provera injections. In women who have had the injections for one year, 50% experienced amenorrhea (lack of menstrual cycles).

    This is not a sign of infertility, but simply an expected side effect of the medication.

    Menstrual cycles will return once the medication runs its course.

      Usually, your period will return within 6 months of the last injection, but it may take longer.

    How Getting Pregnant After Depo Should Work – Ideally

    As long as you want to prevent pregnancy, you need to receive an injection every 90 days. This is because, after 90 days, the levels of Depo-Provera are not high enough for most women to reliably prevent pregnancy.

    Let’s say you want to get pregnant and you discontinue injections.

    You might assume your fertility will return on day 91, but this isn’t how the medication works.

    While the levels of Depo-Provera after 90 days may not be high enough to be considered effective for pregnancy prevention, they may still be too high to get pregnant.

    Some women will get pregnant the very first month after the 90 days, but this isn’t common.

    Most women will see their fertility return within 5 to 7 months of their last injection. In other words, about two months after that 90-day period ends.

    When I say "their fertility will return," I am referring to the return of ovulation and regular menstrual cycles.

    Within 10 months of the last Depo-Provera injection, 50% of women are pregnant.

    Why Depo-Provera Can Cause Temporary Infertility for Up to Two Years

    But not every woman will get their cycle back 5 months after the last injection.

    In some cases, it may take up to 22 months – or almost two years – for fertility to return after the last injection.

    Why does this happen?

    According to the research, the delay seems to be related to a woman’s weight.

    Women who weigh less will have their fertility return faster than women who tend to weigh more. This has to do with how long it takes your body to completely metabolize the progestin.

    How long you’ve used Depo-Provera is not associated with a longer period of lack of ovulation. In other words, whether you used Depo-Provera injections for 6 months or two years doesn’t matter. Your fertility will likely take the same amount of time to return in either case.

    If you received the subcutaneous version of Depo-Provera (as opposed to the older more commonly used intramuscular injection), your risk for experiencing a lack of ovulation for up to two years is significantly less.

    According to at least one study, 97% women who received the subcutaneous version of Depo-Provera had ovulation return after 12 months.

    Take Forum Posts on Depo-Provera with a Grain of Salt

    The most important thing to know is that Depo-Provera is not known to increase your risk of infertility after that those 12 to 22 months.

    In other words, Depo-Provera use is not associated with an increased risk of infertility in general.

    Ovulation (and possibly your menstrual cycles) take awhile to return due to your body not yet metabolizing the medication completely. Not because Depo-Provera has somehow caused a long-term infertility problem.

    With that said, in just about every thread on Depo-Provera on infertility forums, you’ll find women saying their fertility never returned, even after two years.

    Sometimes, they will assume that this was caused by the shot.

    This isn’t backed up by the research.

    Remember that infertility occurs in 1 in 8 couples. This includes couples who choose to use Depo-Provera.

    There will be women who can’t conceive after Depo, even two years after Depo, but this isn’t due to the birth control shot.

    They would have struggled to conceive without Depo-Provera as well.

    What if You Want to Get Pregnant After Depo-Provera?

    Hopefully, your fertility will come back within three or six months after your last shot. This is how it should work, and many women do get pregnant within 8 to 10 months of their last Depo-Provera shot.

    If your cycles are not coming back or you’re not ovulating, and it’s within two years of your last shot, there is unfortunately very little your doctor can do to help.

    Fertility testing is useless, because the possible effects of the hormone in your system won’t allow your doctor to see what else might be wrong. Fertility treatment also can’t be used, due to the hormones still in your system.

    You just need to wait. Which can be extremely frustrating.

    So, when should you see the doctor? If...

    As always, discuss any concerns with your doctor.

    More things you should know:


    Bigrigg A, Evans M, Gbolade B, Newton J, Pollard L, Szarewski A, Thomas C, Walling M. “Depo Provera. Position paper on clinical use, effectiveness and side effects.” Br J Fam Plann. 1999 Jul;25(2):69-76. https://www.ncbi.nlm.nih.gov/pubmed/10454658

    Garza-Flores J, Cardenas S, Rodríguez V, Cravioto MC, Diaz-Sanchez V, Perez-Palacios G. “Return to ovulation following the use of long-acting injectable contraceptives: a comparative study.” Contraception. 1985 Apr;31(4):361-6. https://www.ncbi.nlm.nih.gov/pubmed/3159544

    Jain J1, Dutton C, Nicosia A, Wajszczuk C, Bode FR, Mishell DR Jr. “Pharmacokinetics, ovulation suppression and return to ovulation following a lower dose subcutaneous formulation of Depo-Provera.” Contraception. 2004 Jul;70(1):11-8. https://www.ncbi.nlm.nih.gov/pubmed/15208047

    Kaunitz, Andrew M MD; Zieman, Mimi MD. Depot medroxyprogesterone acetate for contraception. UptoDate.com.  http://www.uptodate.com/contents/depot-medroxyprogesterone-acetate-for-contraception

    Kaunitz AM. “Injectable depot medroxyprogesterone acetate contraception: an update for U.S. clinicians.” Int J Fertil Womens Med. 1998 Mar-Apr;43(2):73-83. https://www.ncbi.nlm.nih.gov/pubmed/9609206

    Zieman, Mimi MD. Patient information: Hormonal methods of birth control (Beyond the Basics). UptoDate.com. http://www.uptodate.com/contents/hormonal-methods-of-birth-control-beyond-the-basics

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