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What Is The Mirena IUD?

The Mirena intrauterine system is a dual-mechanism intrauterine device: it combines the physical presence of the device with a hormonal reservoir containing a type of progestin. Together, these aspects prevent pregnancy by thickening cervical mucus — thereby preventing sperm from reaching the fallopian tubes — and by thinning out the lining of the uterus to make implantation impossible. The Mirena also helps suppress ovulation. 

The Mirena coil is one of the most effective forms of birth control out there, and it can protect women from unwanted pregnancy up to five years. 

Women who choose the Mirena tend to do so because it provides a long-acting and very effective protection against pregnancy that doesn't require active patient involvement after insertion. Another well-known benefit of the Mirena IUD is an immediate return to fertility following removal. Studies reveal that women who have the Mirena remove enjoy an instant restoration of ovarian function and see their normal menstrual cycle return within a month. That means they should, in theory, be able to get pregnant very soon after having their Mirena IUD removed.

What should you do if you had the Mirea IUD taken out in order to begin trying to conceive, but you're not pregnant after, let's say, six months? Is there any chance that your lack of pregnancy has anything to do with the Mirena?

Mirena And The Risk Of PID

The physical presence of any IUD (including the Paragard copper IUD) makes it easier for any infection of the reproductive system to travel upwards, where it can reach the fallopian tubes and ovaries and cause scarring. While such an infection, called Pelvic Inflammatory Disease, can be treated with a course of antibiotics, antibiotics do not reverse the damage caused by the infection. In some cases, the scarring completely blocks the fallopian tubes, making natural pregnancy impossible. In other cases, a fertilized egg can't travel down into the uterus as the result of scarring caused by PID, leading to an ectopic (tubal) pregnancy. 

The Mirena coil protects against unwanted pregnancy, but like all non-condom contraceptives, it does not protect against sexually transmitted diseases that can lead to Pelvic Inflammatory Disease. Should you contract an STD while the Mirena IUD is in place, your risk of PID and resulting infertility rises. This makes the Mirena IUD an unsuitable form of contraception for women who may have contact with STDs. 

Symptoms of PID may include:

  • Nausea and vomiting
  • Pelvic pain
  • Painful urination and sexual intercourse
  • Fever
  • Abnormal menstrual bleeding and discharge

Symptoms are not always obvious, however. Any woman who would like to conceive should ideally be tested for sexually transmitted diseases. If you haven't been tested already, a delay in pregnancy after the removal of Mirena should lead you to go to your doctor, especially if you also have any of the above symptoms. 

How Else Can Mirena Cause Infertility?

Should the Mirena IUD become embedded in your uterus, something that happens in rare cases, your fertility may be affected and you may even need to have a hysterectomy. However, you would be aware that Mirena became embedded in your uterus when you had it removed and would already be familiar with the consequences. 

I Don't Have PID And The Mirena Didn't Become Embedded In My Uterus — Why Am I Not Pregnant Yet?

It can take young, healthy couples up to a year to get pregnant. If you have been tested for STDs and know you don't have PID, and you also know the Mirena didn't become embedded in your uterus, then the fact that you are not pregnant yet has nothing to do with Mirena. You may just need to keep trying a little longer. If you are worried, however, you can see your doctor about infertility after 12 months of trying to conceive, or after six months if you are over 35.

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