How To Get Pregnant After Depo-Provera

Used as a form of contraception, Depo-Provera (medroxyprogesterone) is an injection that keeps you from ovulating. As long as you consistently get the Depo-Provera shot about every three months, it's more than 99% effective at preventing pregnancy.

But what if you've been taking Depo-Provera, and you decide you're ready to get pregnant? Unlike some birth control methods, Depo-Provera may temporarily impact your fertility even after you stop using it, so proper planning is key.

Here's what you need to know about getting pregnant after Depo-Provera.

How Depo-Provera Works to Prevent Pregnancy

Also called "the birth-control shot," Depo-Provera is recommended for people of reproductive age who want to prevent pregnancy for a few months or more. You don't need to remember to take a pill every day the way you need to with an oral contraceptive (aka "the pill"). Instead, you go to a health care provider to get an injection every 12 to 13 weeks.

Every Depo-Provera dose contains progestin, a hormone that prevents your body from ovulating. When you don't ovulate, your body does not release an egg each month, which means that there is nothing for sperm to fertilize. Depo-Provera also makes your cervical mucus thicker, which limits sperm movement, further reducing your risk of pregnancy.

How Long It Takes To Get Pregnant After Depo-Provera

If you want to get pregnant within the next year, Depo-Provera is probably not the best birth control option for you. A single shot of Depo-Provera provides at least three months of protection against pregnancy. Still, research shows that it can reduce your chances of pregnancy for months beyond that, even after you stop getting the shot.

"It's possible to become pregnant after that three-month mark, but it usually takes several additional months for the complete effect of the hormone to dissipate and to begin ovulating and having regular periods again," says Hilda Hutcherson, MD, clinical professor of obstetrics and gynecology at Columbia University Medical Center in New York City.

For some people, regular periods (and with them, ovulation) can return as soon as four months after the last shot. For many others, it will take longer than a year. According to Pfizer, the company that manufactures Depo-Provera, the majority of people who try to conceive after taking Depo-Provera get pregnant within 18 months after their last shot.

Tips for Getting Pregnant After Depo-Provera

If you've been using Depo-Provera as birth control but are now hoping to conceive in the next year or so, there are some things you can do to prepare.

Stop taking Depo-Provera

If you know you want to conceive in the next year, stop taking Depo-Provera right away. It usually takes several months for ovulation (and by extension, your cycle) to return to normal after the injections, and for some people, regular ovulation might not return for more than a year.

In the meantime, use another form of birth control until you're ready to start trying. Consider using a barrier method (like condoms) or long-acting reversible contraception (LARC). Research shows that the rate of pregnancy after discontinuing an intrauterine device (IUD), one popular type of LARC, is the same as for people who haven't been using any birth control method at all.

Watch for signs of ovulation

One question you might have is how to know when Depo is out of your system, especially since many people on Depo-Provera have irregular periods or no periods at all. Since you ovulate before your period, the absence of periods or irregular periods can make it tricky to know when you start ovulating. But there are some signs of ovulation to watch out for, including:

• Ovulation pain or cramping
• Basal body temperature increase
• Cervical mucus changes
• Breast tenderness
• Change in libido
• Light spotting
• Bloating
• Mood changes

You can also do things to track ovulation, like basal body temperature charting or taking ovulation tests. Options like ovulation predictor kits (OPKs) can add up both in time and money, especially if your periods are unreliable or absent. So, you may wish to save those efforts for when your periods are coming more consistently.

Use the time to prepare

Tips on getting pregnant after Depo-Provera are similar to tips on getting pregnant in general. One of them is to prepare for your future pregnancy. Some things to consider include:

• Starting a prenatal vitamin
• Scheduling a pre-conception check-up
• Seeing the dentist for a cleaning and check-up
• Managing chronic health conditions
• Starting or continuing regular exercise
• Stopping smoking, vaping, and drinking alcohol
• Reducing caffeine intake

When to See a Health Care Provider

Most of the time, people will resume fertility within a year of stopping Depo-Provera, but if you've hit that mark and you're worried that you're still not ovulating regularly, make an appointment with a health care provider. In addition, see a health care provider in the following situations:

• You have not resumed your periods within two years after your last Depo-Provera shot.
• You have not gotten pregnant within a year of resuming regular periods and having unprotected penis-in-vagina sex (or six months if you're over 35).
• You have other risk factors for infertility (for example, polycystic ovary syndrome (PCOS) or endometriosis).
  

When stopping Depo-Provera in hopes of getting pregnant, work with a health care provider to determine which birth control method is best for you until you're ready to conceive. Your health care provider can also give you guidance on what to expect when you're ready to start trying.

Remember that everyone's body is different, and there's no way to predict how you will respond to hormonal contraceptives like Depo-Provera. Your best bet is to work closely with a health care provider to figure out what birth control method works best for your body, your lifestyle, and any future family plans.