Can I get pregnant if my IUD moved?

Can I Get Pregnant If My IUD Moved?

An intrauterine device (IUD) is one of the most effective forms of reversible birth control, with a failure rate under 1%. But like any medical device, an IUD can shift from its ideal position. When that happens, its ability to prevent pregnancy may decrease—and you may not even realize it right away. This guide explains what to look for, how shifting affects effectiveness and what steps you can take if you suspect your IUD has moved.

What Does “Moved” Mean?
An IUD sits inside your uterus, with tiny strings extending through the cervix into the vagina. “Movement” can include:

• Partial expulsion: the device has shifted down toward the cervix or partially exited the uterus.
• Complete expulsion: the IUD has come out of the uterus entirely.
• Perforation: in rare cases (about 1 in 1,000), the IUD can poke through the uterine wall.
• Malposition: the device tilts or rotates, no longer centered at the top of the uterine cavity.

How Common Is IUD Movement?

• Copper IUDs tend to shift or expel in 2–10% of users over the first year.
• Hormonal IUDs (like levonorgestrel) have slightly lower expulsion rates (2–5%).
• Higher risk factors include insertion right after childbirth or abortion, heavy periods, uterine anomalies or a history of expulsion.

Signs Your IUD May Have Moved
You may not always feel when an IUD shifts, but common warning signs include:

• Feeling the plastic or strings at the cervical opening (longer or shorter than usual).
• Sharp or persistent pelvic pain on one side.
• Unusual bleeding between periods.
• Cramping that’s more intense than your normal period cramps.
• No strings felt at all (though sometimes strings just curl up).

Any of these symptoms warrants a check—don’t wait until you suspect pregnancy.

How Movement Affects Pregnancy Risk
When properly positioned, IUDs work by:

• Preventing sperm from reaching the egg.
• Inflaming the uterine lining (in copper IUDs) or thinning the lining (in hormonal IUDs).
• Thickening cervical mucus (hormonal IUDs), making sperm movement difficult.

If the IUD moves:

• The inflammatory or progestin effects may no longer cover the entire uterine cavity.
• Sperm can reach the egg more easily.
• Incomplete coverage raises the failure rate—pregnancy risk climbs closer to that of no contraception.

What to Do If You Think Your IUD Has Shifted

1. Check your strings
   • Gently insert clean fingers into your vagina to feel for the IUD strings.
   • Note any change in string length or feel.
2. Avoid intercourse or use backup contraception
   • Use condoms or abstain until you confirm your IUD is in place.
3. Schedule a medical evaluation
   • Your provider can use a speculum exam to locate the strings.
   • An ultrasound is often the next step to confirm the IUD’s position.
4. Consider a free, online symptom check, using the doctor approved Ubie Symptom Checker
   • If you’re unsure how urgent your symptoms are, try the Ubie Symptom Checker (https://ubiehealth.com/) to help prioritize next steps.

Pregnancy With a Moved IUD: What to Watch For
Even if an IUD is no longer doing its job, fertilization and implantation can occur. If you suspect pregnancy with an IUD in place or recently expelled, watch for:

• Missed periods or lighter/spotty bleeding (can be confused with IUD-related spotting).
• Early pregnancy signs: nausea, breast tenderness, fatigue.
• Severe pain or heavy bleeding (could indicate ectopic pregnancy).

Ectopic pregnancy—where an embryo implants outside the uterus—is uncommon but more likely if an IUD isn’t positioned properly. Symptoms include intense one-sided pain, dizziness, fainting or shoulder pain. This is a medical emergency; seek care right away.

Confirming Pregnancy and Next Steps
If you think you’re pregnant:

• Take a home pregnancy test.
• Call your healthcare provider—even if the test is negative but you still have concerning symptoms.

If pregnancy is confirmed:

• Your provider will use ultrasound to locate the embryo.
• If the pregnancy is in the uterus and you wish to continue, they may remove the IUD if the strings are accessible.
• If it’s ectopic, you’ll need prompt treatment (medication or surgery) to avoid serious complications.

Replacing or Removing a Moved IUD
Depending on the situation:

• Repositioning or replacing the IUD may be an option if you still want this form of contraception.
• If you no longer want an IUD, removal is a quick in-office procedure.
• Discuss other birth control methods if an IUD isn’t right for you anymore.

Preventing Future Shifts
While some risk factors can’t be changed, you can reduce chances of IUD movement by:

• Waiting at least four weeks after childbirth or abortion before insertion.
• Scheduling follow-up checks: most providers recommend one exam 4–6 weeks post-insertion, then yearly.
• Learning how your strings feel and checking them monthly.

When to Seek Immediate Help
Contact emergency services or go to the nearest hospital if you experience:

• Severe pelvic pain with dizziness or fainting.
• Heavy vaginal bleeding soaking through pads in under an hour.
• Signs of infection: fever, chills, foul-smelling discharge.

Speak to a Doctor
Any concerning symptom—especially severe pain or heavy bleeding—should be evaluated by a healthcare professional. Your provider can confirm the position of your IUD, test for pregnancy and guide you through the safest next steps. If you ever feel your life is in danger, call emergency services immediately.