When to Stop The Pill Before Trying To Conceive?

by Mona Saint MD

How long should you be off of the birth control pill before starting to try to get pregnant?

Good for you for planning ahead for a healthy pregnancy. We used to recommend stopping the pill and waiting for at least three periods to start trying to conceive. The thought was that this will give your body time to start ovulating and for you to start charting when your last menstrual period occurs. The first date of your last menstrual period (LMP) is an important date for calculating the baby’s due date, and before the advent of good ultrasound machines, this was all that was used for dating the pregnancy. Nowadays, we still ask for the LMP, but we perform an early first trimester ultrasound to compare it to the period date to determine the most accurate due date.

Fortunately, the pill has been well studied and there are no known dangerous risks to the developing fetus if you were taking it when you became pregnant or just stopped the pill and became pregnant. In answer to your question, you can safely take the last pill, have a period, and then start trying to conceive without any increased risks. Some patients conceive right away, and for others it may take months to start having regular cycles and ovulating again. Ultimately, time frame for stopping birth control pills also depends on your medical and social situation.

Some people want to try to do their best to conceive during a certain time of year (e.g. many teachers try to have summer babies), and thus may want more time off the pill to start charting their ovulation and cycle length. Medically, if you have a history of: irregular periods before you began the pill, difficulty conceiving in the past, endometriosis, or are over 35, it may take longer to conceive and thus you might want to factor this in as to when you want to stop the pill. Also, remember to start a prenatal vitamin, schedule a preconception visit with your doctor, avoid alcohol, tobacco and drugs, and be mindful of what prescription and over the counter medications you take before conception. Best wishes for a wonderful pregnancy!