What You Need to Know About Pregnancy After Depo-Provera

Signs of pregnancy after Depo-Provera (medroxyprogesterone) may include a missed period, nausea, frequent urination, and breast tenderness. Many people are able to get pregnant 10 months after their last Depo-Provera shot, but it may take up to 18 months.

Depo-Provera is an injectable birth control given as a shot every three months. It is more than 99% effective at preventing pregnancy. It can be hard to know when Depo-Provera is out of your system and when ovulation will return. If you're considering pregnancy, see your healthcare provider.

How It Works

Depo-Provera is a hormonal birth control method administered by injection (shot.) It contains a hormone that stops the ovaries from releasing an egg, preventing pregnancy. It is given by a healthcare provider every three months.

You should get your first Depo-Provera shot during the first five days of a period to ensure you're not pregnant. (If you get the shot at any other time in your cycle, get a pregnancy test first.) When given during the first five days of a person's period, Depo-Provera provides immediate pregnancy protection.

Side Effects

Before starting Depo-Provera, it is important to discuss potential side effects.

These may include:

• Bleeding and spotting, which may be irregular or prolonged
• Weight gain
• Abdominal pain
• Headache
• Weakness
• Tiredness
• Nervousness
• Dizziness
• Bone density loss (Depo-Provera users should switch to a different birth control method after two years to prevent excessive bone loss)
  
• Depression, which affects about 9% of people who use this form of birth control
  

Stopping Depo-Provera

You can discontinue Depo-Provera by not getting your next injection. After stopping this form of hormonal birth control, your period will go back to normal, but it may take several months. You can still get pregnant even if your period hasn't come back, so it's important to begin using another form of birth control when you stop Depo-Provera unless you're trying to get pregnant.

Getting Pregnant After Depo-Provera

Fertility returns once you've stopped getting Depo injections, but it will take a few months for you to start ovulating. Ovulation is when your body releases an egg (usually each month), enabling you to become pregnant. Although each Depo-Provera injection lasts about three months, it takes an average of six months or more to begin ovulating after discontinuing this birth control method.

How long it takes for ovulation to return depends on several factors, including a person's weight, age, and the dosage level they were taking. One study found the average time was 170 days (five to six months) for people taking the 45 milligram (mg) dose, and 226 days (more than seven months) for those who had been on a 75 mg dose.

Ideally, you should stop receiving Depo injections about one year before you want to become pregnant. An estimated 50% of people who stop using Depo-Provera will get pregnant within 10 months, and the majority do so within 18 months after their last shot. 

Tips For Getting Pregnant After Depo-Provera

It may take some time to get pregnant after Depo-Provera. Here are some tips for conceiving:

• Stop birth control as soon as possible: Ideally, you should discontinue Depo injections about one year before you want to become pregnant.
• See your healthcare provider: They can get you caught up on vaccines you may need, discuss any questions you have, and suggest a prenatal supplement.
• Track your ovulation: Most women ovulate between day 11 and day 21 of their cycle, counting from the first day of their last period. Having sexual intercourse near ovulation is key to getting pregnant.
• Maintain a healthy weight: If you have overweight during pregnancy, it increases the risk of complications, including high blood pressure and miscarriage.
• Don't drink or smoke: Both habits are associated with negative effects on fertility.

Signs of Pregnancy After Stopping Depo-Provera

You'll want to watch for signs of pregnancy after Depo-Provera injections have stopped. Early signs of pregnancy include:

• Missed period
• Nausea and/or vomiting
• Fatigue
• Breast tenderness and/or swelling
• Frequent urination
• Mood changes
• Diet and appetite changes
• Headaches and nasal congestion

If you suspect you may be pregnant, take an at-home test or see your healthcare provider.

When to See a Healthcare Provider

If you're considering pregnancy, discuss your plans with your healthcare provider. They can help assess your overall health and suggest lifestyle changes and prenatal supplements.

When you've stopped taking Depo-Provera but feel you're still not ovulating, be sure to schedule an appointment. That's especially true if:

• Your cycles are still irregular two years after your last injection.
• You don’t conceive within 12 months of ovulation returning (or six months if you're age 35 or older).
• You have other risk factors or signs of a possible fertility problem.

Can Depo-Provera Cause Infertility?

Taking Depo-Provera does not usually lead to permanent or long-term infertility. It's normal for people taking the shots to not have their periods, and there typically is a delay in the return of ovulation once you've stopped taking the shots.

However, the infertility that Depo-Provera causes is temporary. In most cases, the common signs of ovulation return, and infertility does not last more than two years.

Summary

After stopping Depo-Provera, it will take a few months for someone to start ovulating and have regular periods again. To become pregnant, people should stop using this form of birth control as soon as possible and begin tracking their ovulation.

The majority of people become pregnant within 10 to 18 months of their final Depo-Provera injection. See your healthcare provider if you don't conceive within a year after you start ovulating again (or six months if you're 35 or older), or if your cycles are still irregular after two years of stopping birth control.