The contraceptive implant, such as Nexplanon, is a small, flexible rod inserted under the skin of the upper arm that continuously releases the hormone etonogestrel to prevent pregnancy. When the implant is removed, the primary concern is the immediate and rapid return of fertility. Because the contraceptive effect reverses quickly, knowing the correct timeline for pregnancy testing is important for accurately determining pregnancy status. This guide provides clear advice on when to test and what to do with the results.
The Body’s Swift Return to Ovulation
The etonogestrel implant provides highly effective contraception by inhibiting ovulation and thickening the cervical mucus. Unlike the contraceptive injection, which can delay the return of fertility for many months, the implant does not have a long washout period. The hormone etonogestrel is cleared from the body rapidly once the physical implant is extracted from the arm.
The hypothalamic-pituitary-ovarian (HPO) axis, the system regulating the menstrual cycle, can reactivate almost immediately. Studies show that ovulation, the release of an egg, can resume as quickly as within the first month following implant removal. In fact, some women ovulate within weeks, meaning the potential for conception is present right away.
A significant percentage of women resume normal ovulatory cycles and achieve pregnancy within the first year, demonstrating no delay in fertility compared to women who stopped other non-long-acting reversible contraceptive methods. This quick physiological turnaround necessitates immediate consideration of pregnancy testing if a new form of contraception is not started right away.
Calculating the Right Time to Test
A pregnancy test works by detecting Human Chorionic Gonadotropin (HCG), a hormone produced after a fertilized egg successfully implants into the uterine wall. Implantation typically happens six to twelve days after ovulation. Testing too early can result in a false negative because the HCG levels have not yet risen high enough to be detected by the test.
The core timing rule for taking a test is to wait for enough time to pass for implantation to occur and for HCG levels to accumulate. If no period has occurred since the implant removal, you should take a home urine pregnancy test 14 to 21 days after the implant was taken out, or 14 days after the most recent unprotected sexual encounter. The 21-day mark is considered highly reliable for a definitive result from a standard home test.
If you are tracking your cycle and have a known expected period date, the most reliable time to test is on the first day of that missed expected period. For the highest accuracy, a blood test for HCG can be ordered by a healthcare provider. Blood tests are more sensitive and can detect lower levels of HCG earlier compared to a standard at-home urine test.
Interpreting Results and When to Seek Medical Guidance
A positive result on a home pregnancy test, even a faint line, indicates the presence of HCG and suggests a pregnancy. If the test is positive, schedule an appointment with a healthcare provider to confirm the pregnancy and discuss prenatal care. This initial consultation helps to establish an accurate due date and ensure appropriate medical monitoring begins promptly.
A negative test result means that HCG was not detected, which is likely accurate if performed at least 21 days post-removal. If the result is negative but a period still has not arrived, remember that the body is adjusting to the absence of the implant’s hormones. The return to a regular menstrual cycle can sometimes take up to three months as the body’s natural hormone production rebalances.
If you do not get a period and continue to get negative pregnancy tests after three months, you should consult with a healthcare provider. This consultation is important to investigate other potential causes of a delayed or absent cycle, such as anovulation or an underlying condition. Additionally, if a couple is actively trying to conceive, seeking guidance is recommended after six months of unsuccessful attempts if the woman is over 35, or after twelve months if she is under 35.