Pregnancy and IUDs: What You Need to Know

Medically Reviewed by Traci C. Johnson, MD on August 23, 2022
3 min read

You can get pregnant while using an IUD, but it’s very unlikely. Less than 1% of women with copper or hormonal IUDs get pregnant each year.

An IUD should stay in your uterus to prevent pregnancy. But sometimes it can move out of place and slip into your cervix, which is below your uterus. If this happens, you’re more likely to get pregnant.

If you get pregnant while using an IUD, your health and your baby’s could be in danger. Let your doctor know if you think your IUD failed so they can keep you safe.

If your IUD fails, the doctor will find out which type of pregnancy you have:

  • Intrauterine pregnancy: This is a normal pregnancy in your uterus where your baby will grow for 9 months.
  • Ectopic pregnancy: The embryo tries to grow outside your uterus. It usually happens in your fallopian tubes, which carry eggs to your ovaries and then to your uterus. You can also get an ectopic pregnancy in your ovaries, abdomen, or cervix. A pregnancy in one of these areas can’t grow normally. Doctors will end an ectopic pregnancy to protect you from possible bleeding that could put your life at risk.

Since IUDs prevent pregnancies in your uterus, you’re more likely to have an ectopic pregnancy than a regular pregnancy. But this doesn’t mean you’re at a higher risk for ectopic pregnancies in general just because you have an IUD.

If you get pregnant while using an IUD, the doctor will probably try to remove the device. If it stays in, you’re more likely to have a miscarriage, or lose the pregnancy. You also have a higher chance of early birth and infection.

The doctor will use the attached strings to remove your IUD. If the strings have curled up into your cervix, the doctor might need a tool to take the IUD out. They also may use an ultrasound, or a device that takes pictures of things inside your body, to find the IUD so they can remove it.

Sometimes your uterus gets too big to get the IUD out. If that happens, the doctor will leave it in so they don’t hurt you or your baby trying to remove it. After you give birth, the doctor will find the IUD and take it out.

Your IUD may not prevent pregnancy if it:

  • Falls out. If the IUD falls out of your vagina, you aren’t protected against pregnancy anymore. It’s important to check for the strings connected to the IUD to make sure it’s still inside you.
  • Moves out of place. An IUD can also be in the wrong position. It won’t properly protect you if it isn’t correctly fitted inside your uterus.
  • Expires. IUDs have expiration dates. If you keep one in longer than the suggested amount of time, you have a slightly higher chance of pregnancy. You probably won’t have any side effects if you keep an IUD in after it expires, but we need more research to safely recommend this option.
  • Hasn’t started to work. A copper IUD, like Paragard, begins to work right after the doctor inserts it. But hormonal IUDs, like Mirena, don’t start to work for 7 days. Use backup birth control, like condoms, for those 7 days to prevent pregnancy.

If you miss a period, have sore and swollen breasts, feel sick to your stomach, pee more often, or feel more tired than usual, you could be pregnant.

Warning signs of an ectopic pregnancy aren’t usually obvious until later on in the pregnancy. The first signs may be light bleeding from your vagina and pain in your pelvic area. You may also have shoulder pain, or the urge to poop.

Symptoms can get worse as the ectopic pregnancy grows. If you’re bleeding from your vagina, or have signs of shock, like feeling dizzy, faint, breathing fast, or having clammy skin, you could have an ectopic pregnancy that damaged your body.

If you think you could be pregnant with an IUD, see your doctor as soon as possible.