Risks of Becoming Pregnant With an IUD

IUDs (intrauterine devices)—small, flexible devices shaped like the letter T inserted into a woman's uterus through the cervix by a doctor—are one of the most effective reversible methods of birth control available. That said, about 1 in 100 women with an IUD get pregnant each year, and the risk of getting pregnant with an IUD is highest within the first year after insertion.

While it's rare to become pregnant when you have an IUD, if you or your loved one is in this situation, it's important to learn about the risks and complications associated with an IUD pregnancy.

If you suspect you are pregnant with an IUD, here are three steps you should follow. Please note that it's not that uncommon to worry about pregnancy with an IUD. This is because many women experience irregular bleeding in the first few months after IUD insertion. This is then usually followed by lighter and shorter periods; some women stop having periods completely.

If you believe you are experiencing an IUD pregnancy, the first thing you should do is to confirm that you are or are not pregnant. You can take a home pregnancy test or schedule a blood pregnancy test with your doctor.

If a woman becomes pregnant, the use of an IUD puts her at risk for an ectopic pregnancy (a pregnancy where the egg implants outside of the uterus). This is why it's very important to see your doctor promptly if you suspect or confirm a pregnancy with an IUD in place.

If your doctor confirms a viable and non-ectopic pregnancy while your IUD is in place, she will most likely recommend removal of your IUD. It's important to not try and remove the IUD on your own as this is not safe for you or your baby.

It's also important to note that there is a risk of miscarriage when your IUD is removed. That said, your risk of miscarriage rate increases a lot more by choosing not to remove the IUD early on in the pregnancy.

There are a few reasons why your doctor will likely recommend IUD removal for your health and the health of your baby, including increased risks of spontaneous abortion, infection, and preterm delivery. Removing the IUD reduces but does not eliminate these risks.

Again, women who become pregnant with an IUD are more likely to miscarry than women who do not have an IUD in place when conceiving.

Removing the IUD early in pregnancy appears to reduce the risk of miscarriage. However, the risk is still higher than a woman without an IUD who gets pregnant.

In addition to miscarriage, leaving an IUD in place during your pregnancy increases the likelihood of preterm delivery. More specifically, women who have IUDs in place during their pregnancies are up to five times more likely to deliver their baby prematurely than women without an IUD in place. If a woman's IUD is removed early, her risk of having a preterm baby is reduced, but not to zero.

There is always the possibility that an infection called chorioamnionitis may occur in women who have IUDs. Chorioamnionitis—an infection of the membranes that surround the baby as well as the fluid that bathes the baby—is a serious, even potentially life-threatening infection. Like preterm birth and miscarriage, having your IUD taken out decreases this particular risk but does not fully remove it.

There may be a link between becoming pregnant when having an IUD and developing placental abruption, a condition in which the placenta separates from the uterus either before or during delivery.

There are currently five types of IUDs available; four are hormonal (Kyleena, Liletta, Mirena, and Skyla) and one is non-hormonal (ParaGard). If you have become pregnant with a hormonal IUD, your IUD is slowly releasing progestin into your uterus. If you decide to continue with your pregnancy with one of these IUDs in place, the long-term effects of the hormone on the baby are not fully known; however, there does not appear to be an increased risk of birth defects.

Of course, like most medical circumstances, there is a gray area. In other words, there are instances in which a doctor may recommend that a woman not have her IUD removed.

In the end, every woman's situation is unique, so have a thoughtful discussion with your doctor. 

Learning about the possible risks and complications associated with an IUD pregnancy can be overwhelming and scary. But you are already taking a step in the right direction by doing your research and gaining knowledge. Remain proactive and be open and honest when talking with your doctor about the best way to manage your pregnancy.