Does the Pill Make You Infertile? What WHO, NHS, and Research Actually Say
One of the most common fears about birth control pills is that taking them for years will make it harder to get pregnant later. Some people believe the hormones "build up" in your body, or that the longer you take the pill, the longer it takes to conceive.
This is a myth. Here's what the world's leading health organizations and large-scale research actually say.
What the experts say
"Oral contraceptives do not cause infertility, do not change women's sexual behavior, and do not cause birth defects. Fertility returns quickly after stopping either the pill or the mini-pill; there is no delay."
-- World Health Organization (WHO), 2025
"When you stop taking the pill, your fertility usually returns to previous levels after about a month."
-- NHS (UK National Health Service)
"Usually ovulation begins again a few weeks after stopping birth control pills. The hormones in birth control pills don't remain in your system."
-- Mayo Clinic
"There is no need for a 'rest' from taking the pill. Oral contraceptive pills can be used safely for many years, including by adolescents."
-- World Health Organization (WHO)
Do pill hormones "build up" in your body?
No. The synthetic hormones in the pill are metabolized and eliminated within days.
| Hormone | Half-life | Cleared from body |
|---|---|---|
| Ethinyl estradiol (synthetic estrogen) | 13-27 hours | ~2-5 days |
| Levonorgestrel (common progestin) | 19-36 hours | ~4-7 days |
Within about one week of stopping the pill, the synthetic hormones are essentially gone. Your body's natural hormonal system (the HPO axis) then begins to "wake up" and resume normal signaling.
As the International Planned Parenthood Federation (IPPF) states: "After pills are swallowed, they dissolve in the digestive system and the hormones are absorbed into the bloodstream. After they produce their contraceptive effect, the hormones are metabolised in the liver and gut and are then eliminated from the body. They do not accumulate in the body anywhere."
How quickly can you get pregnant after stopping?
Multiple large-scale studies have tracked time-to-pregnancy after stopping the pill. The data is remarkably consistent:
| Time after stopping | Approximate % who conceive |
|---|---|
| First ovulation | Within 2-6 weeks for most women |
| 3 months | ~50% |
| 6 months | ~72-85% |
| 12 months | ~83-87% |
| 24 months | ~91% |
For context, the general pregnancy rate per cycle for women under 35 (without prior contraception) is about 20-25%. The fact that pill users achieve similar cumulative rates confirms no lasting fertility impairment.
Pill users vs. other methods
A 2018 meta-analysis of 22 studies (14,884 women) found that pill users actually had the highest 12-month pregnancy rate of any contraceptive method:
Oral contraceptives: 87% | IUD: 85% | Implants: 83% | Injectable: 78%
Source: Nassaralla et al., Contraception and Reproductive Medicine, 2018
Does taking the pill for 10+ years affect fertility?
This is perhaps the most surprising finding. A landmark Danish study (3,727 women) compared pregnancy rates based on how long women had been on the pill:
| Years on the pill | Likelihood of conceiving (vs. <2 years) |
|---|---|
| Less than 2 years | Baseline (1.00) |
| 4-5 years | 16% more likely (1.16) |
| 8-9 years | 17% more likely (1.17) |
| 10-11 years | 23% more likely (1.23) |
| 12+ years | 28% more likely (1.28) |
Women who used the pill for 12+ years were actually more likely to conceive per cycle than those who used it for less than 2 years. Researchers believe this is because the pill may suppress conditions like endometriosis that can impair fertility.
"Women who have used OCs for many years should be reassured as there was no evidence that long-term OC use has a deleterious effect on fecundability."
-- Mikkelsen et al., Human Reproduction, 2013 (Danish Prospective Cohort Study)
Myths vs. facts
Myth
"The pill causes infertility."
Fact
WHO states directly: "Oral contraceptives do not cause infertility." A meta-analysis of 14,884 women found 87% of pill users conceived within 12 months -- the highest of any method.
Myth
"You need to take a break from the pill every few years to 'reset' your body."
Fact
WHO: "There is no need for a 'rest' from taking the pill." No medical organization recommends periodic breaks.
Myth
"The longer you take the pill, the harder it is to get pregnant."
Fact
The Danish cohort study found the opposite: women on the pill for 12+ years were 28% more likely to conceive per cycle than short-term users.
Myth
"Hormones from the pill accumulate and stay in your body for months."
Fact
Pill hormones are eliminated within about a week. IPPF: "They do not accumulate in the body anywhere." Most women ovulate within 2-6 weeks of stopping.
Myth
"You should stop the pill months before trying to conceive."
Fact
Mayo Clinic: "Conceiving immediately after stopping the pill does not increase your risk of miscarriage or harm to the fetus."
Is there any delay at all?
There can be a small, temporary delay in the first 1-3 cycles. The Danish study found that pill users reached 50% pregnancy by cycle 4, while condom users reached it by cycle 3. But by cycle 7-9, the rates were equal.
This short delay is simply the time your body's hormonal system takes to resume its natural cycle after being suppressed -- not a sign of lasting damage.
What if you have trouble conceiving after stopping?
The pill can mask symptoms of conditions like PCOS or endometriosis (irregular periods, pain) because it regulates cycles. If you have difficulty conceiving after stopping, the underlying condition likely existed before you started the pill -- the pill didn't cause it.
Age is also a factor. Many women start the pill in their teens or twenties and stop years later. Any decline in fertility is due to aging, not the pill.
The bottom line
- Pill hormones leave your body within about a week. They don't build up.
- Most women ovulate within 2-6 weeks of stopping.
- About 87% of pill users conceive within 12 months of stopping.
- Taking the pill for 5, 10, or even 15+ years does not reduce your fertility.
- Every major health organization (WHO, NHS, ACOG, Mayo Clinic) confirms the pill does not cause infertility.
Sources
- WHO - Oral Contraceptives Fact Sheet (2025)
- NHS - What is the combined pill?
- Mayo Clinic - Birth Control Pill FAQ
- ACOG - Combined Hormonal Birth Control
- IPPF - Myths and Facts About the Pill
- Nassaralla et al. - Systematic Review: Return to Fertility After Contraceptive Use (2018, 22 studies, n=14,884)
- Mikkelsen et al. - Long-term OC Use and Fecundability (2013, Danish Prospective Cohort, n=3,727)
- Barnhart et al. - Return to Fertility Following Discontinuation of OCs (Fertility and Sterility, 2009)