What Happens If You Get Pregnant with an IUD?

How Does Pregnancy with an IUD Happen?

Even though IUDs are over 99% effective, a small percentage of people can still become pregnant. The main reasons for this include:

1. IUD Expulsion: Sometimes, the IUD can be pushed out of the uterus without the person realizing it. This leaves them unprotected against pregnancy.
2. Incorrect Placement: If the IUD is not properly inserted, it may not work as intended.
3. Failure to Prevent Fertilization: Though rare, sperm may still fertilize an egg despite the presence of an IUD.
4. Conception Before Insertion: If a person is already pregnant when the IUD is placed, it won’t prevent that pregnancy from continuing.
5. Perforation: In extremely rare cases, the IUD can perforate the uterine wall and move outside the uterus, making it ineffective.

There are two main types of pregnancy that can occur with an IUD:

1. Intrauterine Pregnancy (Pregnancy in the Uterus)

• In some cases, the fertilized egg successfully implants in the uterus despite the IUD.
• Doctors may attempt to remove the IUD early in pregnancy if the strings are visible. If the IUD remains in place, the risk of complications such as miscarriage (50%+), infection, and preterm birth increases.
• If removal is not possible, close monitoring throughout pregnancy is necessary.

• The biggest concern with an IUD pregnancy is an ectopic pregnancy, where the fertilized egg implants outside the uterus, usually in a fallopian tube.
• Ectopic pregnancies can be life-threatening and require immediate medical attention.
• Symptoms of an ectopic pregnancy include severe pelvic pain, vaginal bleeding, dizziness, and shoulder pain.

If you have an IUD and suspect you might be pregnant, watch for these symptoms:

• Missed period (if your cycles are usually regular).
• Light spotting or abnormal bleeding (this can be a sign of ectopic pregnancy).
• Lower abdominal pain or cramping.
• Breast tenderness, nausea, or other common pregnancy symptoms.
• A positive pregnancy test.

If you experience sharp pain, dizziness, or heavy bleeding, seek medical attention immediately, as these could be signs of an ectopic pregnancy.

1. Take a Pregnancy Test: If you suspect pregnancy, test as soon as possible.
2. See a Doctor Immediately: An ultrasound will confirm if the pregnancy is inside the uterus or ectopic.
3. Discuss IUD Removal: If the pregnancy with an IUD is intrauterine and the IUD strings are accessible, removal is often recommended to reduce risks.
4. Monitor for Complications: If the IUD cannot be removed, frequent medical monitoring will be necessary to ensure a safe pregnancy.

• Miscarriage – If the IUD remains in place, miscarriage risk is 50% or higher.
• Ectopic Pregnancy – About 1 in 2 pregnancies with an IUD are ectopic.
• Preterm Birth – Increased risk of early labor and low birth weight.
• Infections – Higher risk of a serious uterine infection (chorioamnionitis).

Yes, it is possible to have a healthy pregnancy with an IUD, but the risks are higher than normal pregnancies. If the IUD can be removed safely, the chances of carrying a healthy baby improve significantly.

If the IUD remains in place, careful monitoring is required to reduce complications. Some women have delivered healthy babies despite an IUD, but they need frequent check-ups to ensure everything is progressing safely.

Getting pregnant with an IUD is rare, but it requires immediate medical attention. If you suspect pregnancy, take a test and consult a doctor to confirm its location. The main risks are miscarriage, infection, and ectopic pregnancy, but with proper medical care, a healthy pregnancy is possible.

References

1. American College of Obstetricians and Gynecologists (ACOG). “Long-Acting Reversible Contraception (LARC): IUDs and Implants.” 2023.
2. Centers for Disease Control and Prevention (CDC). “Effectiveness of Birth Control Methods.” Updated 2023.
3. Allen, R. H., & Goldberg, A. B. (2022). “Pregnancy Outcomes with Intrauterine Devices in Place: Risks and Management.” Obstetrics & Gynecology Journal.
4. Lippincott Williams & Wilkins (2021). Management of Contraceptive Failures. In: Berek & Novak’s Gynecology, 16th Edition.