Guidance and Support: Pregnant with IUD

What Is the Likelihood of a Pregnancy with IUD?
Causes — Four Possible Reasons
Am I Pregnant Despite Having an IUD?
Unplanned Pregnancy Despite IUD — Tips
Facts About IUDs

The Pearl Index for the copper IUD is between 0.3 and 3, meaning up to three in 100 women become pregnant each year despite copper IUD.
→ More information on copper IUDs

The Pearl Index for using a copper chain is 0.1 to 0.8. This means 1–8 in 1000 women become pregnant while using the copper chain for contraception.
→ More information on copper chain IUDs

Conclusive studies on the reliability of the copper ball are not yet available. However, the Pearl Index is assumed to be similar to the copper IUD or the copper chain. According to the manufacturer, the Pearl Index is 0.5 to 0.7, meaning five to seven women in 1000 become pregnant despite using the copper ball.
→ More information on copper ball IUDs

Here the Pearl Index is 0.3–0.7. This means three to seven women in 1000 who use a gold coil for contraception still become pregnant each year.
→ More information on the Gold T® IUD

The Pearl Index for hormonal IUDs is 0.05–0.3. This means up to 3 in 1000 women will become pregnant while using a hormonal IUD.
→ More information on hormonal IUDs

Stainless steel rings are far less effective than all other IUDs. Therefore, they are no longer in production. Since the SSR stays in place for up to 20 years, some women still use this contraceptive method.

Depending on the model, a copper IUD can usually remain in the uterus for up to five years. By then, the supply of copper ions, which prevent pregnancy by affecting sperm and uterine lining, is depleted. The same holds true for the copper chain and the copper ball.

Depending on the model, hormonal IUDs can remain in the uterus for three to five years. The artificial hormone, progestin, is then depleted, and the IUD can no longer affect the cervical mucus or uterine lining.

The fit of the IUD can be checked using the removal strings, which hang out of the cervix toward the vagina. The IUD may have slipped too far into the uterus if the strings are no longer present. If the strings are longer than usual, the IUD may have slipped too low.

Copper IUDs slip in 1–3% of cases. Therefore, your gynecologist will inspect the position of the IUD during your regular check-ups. If your IUD is not positioned correctly, you may become pregnant.

Hormonal and copper IUDs (including copper chains and copper balls) can be expelled during your period without you even noticing.

The odds of this happening are exceptionally high in the first few months after the IUD has been inserted: This occurs in 0.5 to 10% of predominantly young women. The likelihood is even greater if the IUD was inserted after giving birth: 12 - 31% of women lose the IUD without noticing it.

If the IUD strings are no longer tangible, or your menstruation is suddenly stronger than usual, your IUD may have come out.

Due to material defects, an IUD can break, causing it to no longer be correctly positioned in the uterus.

The doctor also has to select the correct size of the IUD. This is determined according to the uterus's size, shape, and position. If the wrong size of IUD is selected, the IUD may not fit properly. Note: Some countries, such as the US, do not provide smaller sizes.

• The copper IUD is inserted directly into the uterus by the gynecologist.
• If something is located inside the uterus, it is called intrauterine. This is why IUDs are called IntraUterine Devices.
• The copper IUD is T-shaped and consists of a copper wire and plastic. It does not contain any hormones. The contraceptive effect is due to the release of spermicidal copper ions. Copper ions also affect the uterine lining, preventing the implantation of any fertilized egg.
• You can check the position of the IUD at any time by the removal strings that extend through the cervix toward the vagina.

• The copper chain, known by the trade name Gynefix®, consists of a nylon string covered with several small copper sleeves. Using a special insertion device, the line is fastened to the muscles of the uterine wall by a small knot to keep the copper chain in place.
• The copper chain works like any copper IUD: The copper ions released by the tubes limit the sperm's fertilizing ability. The uterine wall is also affected. As a result, fertilized eggs are prevented from implanting in the uterine lining.
• Copper chains are not available in the US.

• Because the copper ball is also inserted directly into the uterus by a gynecologist, it is also known as an intrauterine ball (IUB).
• Like the copper IUD, this is a hormone-free contraceptive.
• The copper ball consists of a polymer-coated alloy wire threaded with small copper spheres. Upon insertion in the uterus using a special device, it takes the original three-dimensional spherical form.
• The copper ions released have a spermicidal effect and affect the uterine lining, preventing the implantation of a fertilized egg.
• Copper balls are not available in the US.

Strictly speaking, the Gold T® is a copper coil with a gold core. While the effect is identical to any other copper IUDs, the gold core prevents the copper wire from premature wear and tear, making it more durable.
Gold Ts are not available in the US.

• As the name suggests, hormonal IUDs are a type of hormonal contraceptive.
• A hormonal IUD is a t-shaped piece of plastic that the gynecologist inserts into the uterus.
• Hormonal IUDs contain the hormone progestin, which is continuously released into the uterus in small amounts. This causes a thickening of the cervical mucus at the cervix, preventing sperm from passing through. Additionally, sperm cells are inhibited in their ability to move and fertilize. The uterine lining is also thinned, preventing the implantation of a potentially fertilized egg.

• Stainless steel rings, known as Chinese rings or Shanghai rings, used to form the backbone of birth control in China.
• The ring is 1” in diameter and does not have a removal string, making its removal difficult, even for a physician. The rationale behind the lack of removal capabilities was the political agenda of the one-child policy in China.
• The ring was used for post-placental insertion, within ten minutes of the delivery of the placenta, after the birth of the first child.
• It is estimated that 50,000,000 women have had a ring inserted.
• Copper IUDs are increasingly replacing the stainless steel ring because of their higher effectiveness and lower infection rates.

A pregnancy despite an IUD is very rare but still possible. This can happen if the IUD has shifted, has been expelled without being noticed, or has been in place for too long. Once you find out you are pregnant, have your IUD removed as soon as possible. Keeping it in place could lead to complications such as infection, inflammation, and an increased risk of miscarriage. Even if you are unsure whether to continue the pregnancy, it is still advisable to ask for the removal of the IUD.
Caution: The risk of ectopic pregnancy is higher with an IUD in place. If you are experiencing pain or spotting, seek immediate medical attention.

The typical symptoms of pregnancy also apply to pregnancy with an IUD, such as nausea, breast tenderness, or a missed period. If you are experiencing signs of pregnancy, especially if your period is late, take a pregnancy test or see your doctor to gain clarity. For an initial evaluation, take Profemina's Online Pregnancy Test. Should you be pregnant while the IUD is still in place, have your doctor remove it as soon as possible. An IUD would increase the risk of an ectopic pregnancy and other complications.

Getting pregnant despite an IUD is very rare but not impossible. It can occur if the IUD has slipped, has stayed in the uterus too long, or has fallen out. A woman usually notices a pregnancy by typical pregnancy symptoms, including a missed period. Should you experience light bleeding while pregnant, this is not your menstruation. Rather, the bleeding is most likely triggered by implantation. For more information, go to the Profemina article Period while Pregnant.
Note: Seek medical attention if you feel unsure about your symptoms, are experiencing unfamiliar pain, or are spotting. You may be having an ectopic pregnancy, which is more common with IUDs.