Can you get pregnant with an IUD still in place?

It's a small chance, but yes. Both the copper coil (IUD) and the hormonal coil (IUS) are over 99% effective, which means fewer than 1 in 100 people using one will get pregnant each year.

The two types work differently. The copper IUD contains no hormones. It releases copper into the womb, which stops sperm reaching an egg. The hormonal IUS releases a small amount of progestogen. This thickens cervical mucus and thins the womb lining, and in some people it also stops ovulation. Both are highly reliable, but "over 99% effective" always leaves room for that rare exception.²

If your coil has moved, can you still get pregnant?

Yes, and this is one of the main reasons the small risk exists. A coil can shift out of position or come out entirely (expulsion). This is more likely to happen in the first few months after it's fitted. If it's moved, it's not doing its job properly, so the pregnancy risk goes up.³

Your IUD has two thin threads that hang down slightly into the top of your vagina. You should be shown how to check for them and told to do so a few times in the first month, then regularly after each period. If you can't feel the threads, or they feel longer or shorter than usual, don't assume everything's fine. Use condoms as backup and contact a sexual health clinic, your GP, or 111 straight away. You may need emergency contraception if there's been a chance of pregnancy.

Symptoms of pregnancy with an IUD in place

The early signs are the same as any pregnancy: a missed period, light spotting known as implantation bleeding, nausea, sore or tender breasts, and unusual tiredness. If you have any of these while your coil is in, it's worth taking a home pregnancy test.

One thing to take seriously: contact your GP or call 111 without delay if you have pelvic pain, unusual bleeding, or shoulder tip pain alongside a positive test. The same applies with a negative test if you still strongly suspect you're pregnant. Pregnancies that occur with a coil in place carry a higher relative chance of being ectopic, meaning the pregnancy has implanted outside the womb, usually in a fallopian tube. This isn't meant to alarm you. It's rare, but it needs quick medical assessment rather than a wait-and-see approach.

What happens to fertility after IUD removal?

Here's the reassuring part. Unlike some hormonal contraceptives that can take a few months to fully leave your system, an IUD or IUS doesn't linger. NHS guidance is direct on this: after either type of coil is removed, your fertility returns to previous levels straight away. There's no waiting period built in, no hormone to flush out, no delay to "catch up" on.

That's true for both the copper coil and the hormonal coil. The mechanism each one uses to prevent pregnancy stops working the moment the device is out, so your cycle can pick back up where it would naturally be.

Can you get pregnant 1 week after IUD removal?

Yes, this is entirely possible. Ovulation can happen within days of removal, especially if your cycle was already running close to a fertile window when the coil came out. Sperm can also survive in the reproductive tract for up to five days, so if you have unprotected sex in the days just before or after removal, pregnancy can follow quickly.

This cuts both ways. If you're not ready to conceive yet, NHS advice is to start using another form of contraception from 7 days before your removal appointment, such as condoms. If you are trying to conceive, it means you genuinely don't need to "wait a cycle" before you start.⁵

Practical steps if you're trying to conceive after IUD removal:

There's no way to guarantee timing, nobody can promise a specific number of weeks or cycles. But there are things you can do from day one that put you in a good position once your body is ready.

Start tracking ovulation straight away. Don't wait a cycle to "let things settle." Using an ovulation test kit from cycle one helps you identify your fertile window even if your first cycle after removal is a little unpredictable.

Have regular sex through the fertile window. Every 2 to 3 days across the month, with extra focus around ovulation, gives sperm the best chance of being present when an egg is released.

Look after the basics. A healthy, balanced diet and a weight that's right for your body both play a role in regular ovulation and overall fertility.

Start folic acid and vitamin D before you try. NHS advice is to take a daily 400 microgram folic acid supplement from when you start trying (ideally 3 months beforehand) until 12 weeks pregnant, and a 10 microgram vitamin D supplement, particularly between October and March.⁶

Get the pre-pregnancy basics sorted. This includes checking your cervical screening is up to date and considering an MMR vaccine if you haven't already had one.⁷

Track your cycle and ovulation early:

Your first cycle after coil removal, especially after a hormonal IUS, can sometimes be a little irregular before it settles into its natural rhythm. That's exactly why tracking from the start matters. An ovulation test kit measures the hormone surge that happens shortly before you release an egg, so you can pinpoint your fertile window rather than guessing based on a "typical" 28-day cycle that might not match yours yet.

Give your body a realistic timeline.

It helps to hold two things at once here: it's genuinely possible to conceive in your first cycle after removal, and it's also completely normal if it takes longer. NHS data shows that more than 8 out of 10 couples where the woman is under 40 will conceive naturally within a year of trying, with regular unprotected sex every 2 to 3 days. A handful of cycles without a positive test isn't a sign anything is wrong. It's simply within the normal range.⁸

Why am I not getting pregnant after IUD removal?

If it's been a few months and nothing's happened yet, take a breath first. A short wait is genuinely normal — most conception happens within the first year of trying, not the first cycle.

If more time has passed, a few things beyond the coil itself can affect how long it takes:

Irregular ovulation. Not everyone ovulates like clockwork, and cycles can take a little while to find their pattern.

Age. Fertility naturally declines with age, and this becomes more noticeable from the mid-30s.⁹

Underlying conditions. Things like endometriosis, PCOS, or thyroid issues can affect how easily you conceive, regardless of what contraception you used before.

As for when to see your GP: NHS guidance recommends speaking to a doctor if you haven't conceived after a year of regular unprotected sex. If you're 36 or over, don't wait — current NICE guidance recommends offering a referral for specialist advice straight away, rather than waiting the full year, precisely because fertility declines faster from this point. The same applies if you're already aware of a fertility concern. There's no harm in raising it earlier if something feels off to you. A GP can run basic checks for both partners and rule out anything that needs attention.

What happens if you don't get your IUD removed?

IUDs and IUS coils are licensed for a set number of years. IUDs last 5 or 10 years depending on the type, while IUS coils last 3 to 8 years. Once that time is up, the device isn't guaranteed to keep working as effectively. Leaving it in place beyond its licensed lifespan isn't recommended, particularly if you're trying to conceive.

If you're not sure when yours is due for removal, check with your GP or the clinic that fitted it. Booking a removal appointment at a GP surgery or sexual health clinic is straightforward, and NHS contraception services are free. There's no need to wait for your next scheduled check-up if you know you're ready to start trying.

Give your body extra support while trying to conceive.

Getting your coil removed is a big first step. What comes next is often about finding practical ways to make the most of your fertile window each month. This is where twoplus can fit into the picture.

Our female and male fertility supplements are formulated to support reproductive health for both partners while you're trying to conceive. Alongside that, our ovulation test kits help you pinpoint the fertile window we talked about above, so you know when the timing is right rather than relying on guesswork. And for couples who want a bit more control over how and when they try each month, the twoplus Applicator Extra device is an at-home option. It deposits sperm close to the cervix, in the comfort and privacy of your own home, on your own schedule. It's produced in a clean room and classified as an ICI (intracervical insemination) device. If you have any concerns about your fertility, it's always worth discussing them with your GP alongside using tools like these.

Frequently asked questions

How long after IUD removal does it take to get pregnant? It varies from person to person. Some conceive within the first cycle, others take several months. NHS data shows over 8 in 10 couples where the woman is under 40 conceive within a year of trying.⁸

Can you get pregnant straight away after having a coil removed? Yes. Fertility returns to previous levels immediately after removal, so pregnancy can happen from your very first cycle, even within a week if ovulation occurs soon after.⁴

Does having an IUD for a long time affect future fertility? No. Long-term IUD or IUS use doesn't reduce your future fertility. Once removed, your body's natural fertility returns straight away, regardless of how long you had it fitted.⁴

Do I need to wait for a period before trying to conceive after IUD removal? No. There's no medical need to wait for a period first. Ovulation can happen before your next bleed would have arrived, so you can start trying as soon as the coil is out.

Sources

1. NHS – What is an IUD (intrauterine device) or copper coil?: https://www.nhs.uk/contraception/methods-of-contraception/iud-coil/what-is-it/
2. NHS – What is an IUD (intrauterine device) or copper coil?: https://www.nhs.uk/contraception/methods-of-contraception/iud-coil/what-is-it/
3. Sexual Health South West London – Intra-uterine Contraception: https://shswl.nhs.uk/contraception/Intra-uterine-Contraception
4. NHS – What is an IUD (intrauterine device) or copper coil?: https://www.nhs.uk/contraception/methods-of-contraception/iud-coil/what-is-it/
5. NHS – Getting an IUD (intrauterine device) or copper coil fitted or removed: https://www.nhs.uk/contraception/methods-of-contraception/iud-coil/getting-it-fitted-or-removed/
6. NHS – Pregnancy vitamins and supplements: https://www.nhs.uk/pregnancy/keeping-well/pregnancy-vitamins-and-supplements/
7. NHS – Vitamins and supplements in pregnancy: https://www.nhs.uk/best-start-in-life/pregnancy/vitamins-and-supplements-in-pregnancy/
8. NHS – Infertility: https://www.nhs.uk/conditions/infertility/
9. NHS – Diagnosis of infertility: https://www.nhs.uk/conditions/infertility/diagnosis/