Nexplanon, a small, flexible implant, serves as a highly effective, long-acting reversible contraceptive (LARC). Placed discreetly under the skin of the upper arm, it offers continuous pregnancy prevention for up to three years. Many wonder about the timeline for fertility to resume after its removal. This article explores the process and factors influencing conception.
Understanding Nexplanon and the Removal Process
Nexplanon works by continuously releasing a progestin hormone called etonogestrel. This hormone prevents pregnancy by stopping ovulation. Additionally, it thickens cervical mucus, hindering sperm from reaching an egg, and alters the uterine lining, making it less receptive to implantation.
The removal of Nexplanon is a straightforward, quick procedure performed in a healthcare provider’s office. A local anesthetic is administered to numb the area, ensuring minimal discomfort. A small incision, typically 2-3 millimeters, is then made, and the implant is gently removed using forceps.
The Rapid Return of Fertility
Fertility can return quite quickly after Nexplanon removal because the body rapidly clears the etonogestrel hormone. Etonogestrel levels drop after removal, and ovulation can resume within weeks. Some individuals may ovulate and become pregnant in their first menstrual cycle following removal.
Studies indicate that pregnancy is possible as early as the first week after the implant is taken out. While the contraceptive effect is reversible almost immediately, individual responses can vary. Most women find their fertility returns quickly, often within days or weeks, allowing them to pursue conception.
Additional Factors Influencing Conception
A person’s age significantly impacts fertility, as the quantity and quality of eggs naturally decline over time, affecting conception rates. Overall health and lifestyle also play a role in fertility. Factors such as diet, regular exercise, smoking, alcohol consumption, and stress can all affect the ability to conceive. Maintaining a healthy weight is beneficial, as being overweight or underweight can disrupt ovulation and menstrual cycles.
The regularity of menstrual cycles before Nexplanon use, and after its removal, also influences conception. Underlying conditions such as polycystic ovary syndrome (PCOS) or endometriosis can impact fertility independently of prior contraceptive use. Additionally, male factor infertility can affect a couple’s ability to conceive.
What to Expect After Removal
After Nexplanon removal, the body undergoes hormonal adjustments. This adjustment period can lead to temporary physical changes and symptoms. Many individuals will experience the return of menstruation, though the first period might differ from their pre-Nexplanon cycles.
Bleeding patterns can vary, potentially being irregular, heavier, or lighter as the body re-establishes its hormonal rhythm. Some may experience temporary side effects like mood changes, headaches, breast tenderness, or acne as hormone levels rebalance. These symptoms are typically short-lived, usually resolving within a few days to a few months.
Preparing for Conception and Seeking Support
For individuals planning to conceive, proactive steps can help prepare the body for pregnancy. Taking a daily folic acid supplement (400-800 micrograms) is recommended at least one month before trying to conceive and throughout the first trimester. This helps reduce the risk of certain birth defects. Maintaining a healthy weight, eating a balanced diet, and avoiding smoking and excessive alcohol consumption are also important preconception practices.
Tracking menstrual cycles and ovulation can help identify fertile windows, increasing the chances of conception. If conception does not occur, seeking medical advice is a reasonable next step. Guidelines suggest consulting a doctor after 12 months of trying for those under 35, or after 6 months for those 35 and older. Consultation is also advised sooner if there are known fertility concerns or pre-existing conditions.