Has Mirena trashed my fertility?

[ForenameSurname]

Had Mirena taken out in October 2020 as husb and I are TTC. First period totally skipped. Second period was light and over in a day or two. Third and fourth period were the same. Did not get pregnant.

Bought an ovulation kit to try and see what was going on. Had a mini-surge of LH (up to 36% at its highest point) this month pre-(supposed) ovulation and then it went back to... nada. So, I'm guessing no ovulation has been occurring. (Side note: feeling really cross that the doctors don't mention this either before you get the Mirena or when you have it take out.)

Now at this point I'd be thinking maybe I have a chronic fertility issue. But I've been pregnant twice before so it strikes me as unlikely. I'm a little concerned, as a gynaecologist identified that I had very low-grade pre-CN1 on my cervix back in September 2020. She told me to wait for a smear in a year's time to see if it cleared itself up (which apparently it can do). Is there any chance that the lack of ovulation/pregnancy could be to do with this? Should I get a private check up on my internal lady parts to see if all is well?

I've order some vitex (chasteberry), as a pal recommend it for regulating cycling and boosting progesterone and prolactin, which I've read can be deficient in women who have been on hormonal birth control long-term. Anyone had any experience with this before? I've read some comments online that it works wonders, but I'm always nervous about anything supplementary!

Sorry for the mad ramblings - any advice or words of support would be really welcome!

It's been 4 months. Chill.

It can take a while for fertility to come back after hormonal contraception.

However - in case it doesn't sort itself out, it's extremely unlikely to be down to the coil. Just because you have previously been able to get pregnant doesn't mean you're still fertile - my fertility went from totally normal to peri-menopausal in my early 30s, no known reason. Just one of those (extremely shit) things.

Give it a few months (unless you're over 35 in which case act now) and then go to your GP for tests.

@MissLucyEyelesbarrow You're right about that. I do need to chill!

I'm just feeling super tense about it because my previous two pregnancies were a result of the only two times I've had unprotected sex. The frustration, then, of not getting pregnant when you actually start trying is all kindsa maddening!

@HavelockVetinari Yeah, I guess you're right. I just wish they would warn women about these things, so we're not all left scratching our heads, worrying and scouring internet forums for answers. All they said was, "You could get pregnant straight away!" Would it kill them to add, "But don't worry if your fertility doesn't come back straight away because that happens a lot!"

Sorry to hear about your sudden peri-menopausal turn. Isn't it wild that they don't have any explanations for these things? What can be done? More funding for more research?

@ForenameSurname I don't think it's fair for anyone to be telling you to "chill" tbh, ttc is an intense time for everyone whether it's been one month or one year. You're right to be tracking and checking for ovulation. I'd maybe give it another two Cycles of tracking and if you are still concerned you aren't ovulating then chat to your gp. It can take a while for things to return to normal after hormonal contraceptives, but you should be ovulating at this point I'd say, even if not regularly. Everyone is different, but like I said any concerns you have are valid so don't be put off by asking questions because someone said to chill!

I was on Mirena after DS, then had it taken out to TTC - took a couple of months before conceiving DD. I think it helped that we weren't really trying our hardest if you know what I mean ana were v relaxed about it. Good Luck!!

I'd be cautious about messing with herbs or vitamins when you dont know what is suppressing ovulation- for example when coming off the pill I wasnt ovulating cause my prolactin was too HIGH so adding vitex wouldnt have been a good idea for me.

Just to check - you've been using OPKs every day for the 4mp and not hit a peak?

How much older are you now? It’s normally just that you’ve got older and it takes longer to fall pregnant

@Fifi1086 Yeah, I hear you. I should have probably been more sensitive to the fact that women on here have been trying for ages. It's just really hard to chill, having got pregnant before on the 2 occasions I have unprotected sex in the last 15 years! I just assumed I was irritatingly fertile, so I was surprised and more than a bit disappointed to find it not happening right away... Seems frustratingly ironic.

@TheDaydreamBelievers You are right to urge caution. When I opened them today, I suddenly got a feeling of "Oh sh*t, is this the right thing to do?" so I'm feeling very swayed. How did you come to know your prolactin was too high?

@justanotherneighinparadise I'm 31. I last got pregnant at 27, so not a huge jump in time, but maybe enough for my fertility to take a sudden nosedive? (The only difference between now and then has been the Mirena, which is why it was my No.1 culprit.)

*some women. (Sorry, I hit 'post' instead of 'preview' - Mumsnet newbie with tired eyes!)

If you had no periods with the Mirena it can take a while for them to return fully. Preventing ovulation isn’t the main mechanism of action of the Mirena - happens to some, but not the majority - but if it’s been out for a few months that effect (if it was happening) should have worn off.
Don’t assume you’re not ovulating - if you’re having regular periods you likely are.
FWIW I never got a “surge” on the ovulation sticks but I had other signs of ovulation. Are you tracking your temps or cervical mucus? For me these were much more reliable than those sticks which caused more stress than anything. My best friend had the same and she’s conceived 4 times!
Also it’s very unlikely to be related to the changes in your smear test.
Good luck, it is stressful

@ForenameSurname blood tests when my period didnt return for 6 months!

[quote Fifi1086]@ForenameSurname I don't think it's fair for anyone to be telling you to "chill" tbh, ttc is an intense time for everyone whether it's been one month or one year. You're right to be tracking and checking for ovulation. I'd maybe give it another two Cycles of tracking and if you are still concerned you aren't ovulating then chat to your gp. It can take a while for things to return to normal after hormonal contraceptives, but you should be ovulating at this point I'd say, even if not regularly. Everyone is different, but like I said any concerns you have are valid so don't be put off by asking questions because someone said to chill![/quote]
I said chill because it's totally normal for it to take 3 cycles for ovulation to return after stopping progesterone-only contraception. Some women get an immediate return of ovulatory cycles but lots don't. So you telling the OP that she should be ovulating is incorrect. Nor is it helpful to encourage women to feel anxious when there is no need to be.

Trying to relax and not be anxious is the best advice because there is no reason to think anything is wrong. Someone like the OP who had regular cycles pre-IUS, and who has had a 100% pregnancy rate with UPSI in the past has (depending on her age) about a 90% chance of becoming pregnant within a year of stopping contraception.

I'd absolutely never encourage anyone to feel anxious, just that if she is concerned to check with her gp, and that tracking ovulation is a positive thing to do to stay in tune with your cycle and fertility. In majority of cases mirena does not stop ovulation, and cycle should regulate 3 months post removal. But like I said everyone is different.

I imagine everybody is different but Mirena didn't impact my fertility. I had my coil removed in the December and was pregnant by the following March. I was 41 and expecting it to take ages

How long were you on it for OP? I was on the pill for over a decade and it took my periods nine months to settle. I waited six months between coming off the pill and TTC with my second baby. I got pregnant straight away with him. I had the injection after him and it took six months for my periods to return after it.

When you look online, it can take up to a year to conceive after most hormone contraception. The only one that is proven to have long term implications for fertility is the injection (which was one of the reasons I had it)

No I doubt your fertility has taken a big nose dive at that age. I would imagine it’s just going to take a few months for your hormones to regulate again.

Don’t worry xx

There’s a fine balance between being proactive with your health and not worrying unnecessarily, isn’t there? Research into women’s bodies and the varying effects of, for instance, contraceptives could be miles better - or at least better communicated. Lack of knowledge leaves us anxious, wondering if we’re the rare medical anomaly.

I fully accept that it’s probably paranoia at this point. It’s also the guilt of having two unwanted pregnancies that’s playing tricks with my mind about being ‘undeserving’. Not a healthy thought to entertain, I know.

As ever, the moral of the story is: don’t comb the internet for stories about Mirena and fertility. You’ll only find worst case scenarios and that does nothing to calm the mind!

Thanks all for your reassurance and advice x

If you do get worried, you could always go for a private consultation - about £250 iirc and it might give you peace of mind. I know what it's like feeling powerless and clueless about your own body, and of course being stressed can in itself affect your periods. Biology, eh?

Good luck anyway, and if you do get it resolved come back and update the thread so that future Googlers can read a happy resolution!