You cannot intentionally get pregnant while on Nexplanon; you must have a doctor remove the implant to restore fertility, which often returns within days.
Many women love the “set it and forget it” ease of the birth control implant. But when your plans change and you decide you are ready to start a family, you might wonder exactly how to make that transition. The phrasing “getting pregnant on Nexplanon” usually comes from two different concerns: worrying about an accidental pregnancy while using it, or wanting to know the steps to conceive after taking it out.
For those trying to conceive, the process is straightforward but requires medical assistance. You cannot just stop taking it like a pill. The implant releases hormones continuously until a professional removes it from your arm. Once it is gone, however, your body bounces back remarkably fast. Unlike some contraceptive shots that linger in your system for months, the implant’s effects wear off almost immediately, clearing the path for pregnancy.
This guide explains the removal process, how quickly your fertility will return, and what you can do to prepare your body for a healthy pregnancy the moment the device is out.
Understanding How The Implant Prevents Pregnancy
To understand why you cannot get pregnant while the device is active—and why fertility returns so fast—you need to know how it works. Nexplanon is a small, flexible rod placed under the skin of your upper arm. It steadily releases a progestin hormone called etonogestrel.
This hormone works in three distinct ways to keep you from conceiving:
- Stops Ovulation: It prevents your ovaries from releasing an egg. Without an egg, sperm have nothing to fertilize.
- Thickens Mucus: It changes the consistency of the mucus on your cervix, making it thick and sticky. This acts like a wall that stops sperm from swimming to the uterus.
- Thins the Lining: It suppresses the growth of the uterine lining, so even if an egg were fertilized, it would struggle to implant and grow.
As long as the rod is in your arm, these protections are active. The failure rate is incredibly low—around 0.05%. This means fewer than 1 in 1,000 women will get pregnant with the implant in place. Therefore, if your goal is to have a baby, the rod must come out first.
The Removal Procedure: The First Step
Getting pregnant starts with a visit to your healthcare provider. You cannot remove the implant yourself. The removal appointment is usually quick, often taking less than 20 minutes. It is a minor procedure done right in the doctor’s office.
Your doctor will feel your arm to locate the implant. They will clean the area and inject a local anesthetic to numb the skin. This stinging sensation from the numbing shot is usually the only pain you will feel. Once the area is numb, the doctor makes a tiny incision near one end of the implant and gently pushes it toward the opening. They grasp it with forceps and slide it out.
After removal, your arm will be bandaged. You might have some bruising or soreness for a few days, but you can return to normal activities immediately. More importantly, the hormone supply is cut off instantly. Your body begins to clear the remaining etonogestrel from your blood right away.
Since the hormone leaves your system so quickly, you don’t have the “waiting period” associated with methods like the Depo-Provera shot. Your natural cycle begins to wake up the moment the device is gone.
Fertility Return Timeline
Speed is one of the biggest benefits of this method if you want to conceive. You do not need to wait months for your cycle to regulate. Medical data shows that ovulation can restart in as little as a week or two for many women.
The table below outlines what typically happens in your body during the first few weeks after your appointment.
| Time Since Removal | Physical Changes | Fertility Status |
|---|---|---|
| 24–48 Hours | Etonogestrel levels in blood drop to undetectable levels. | Hormonal suppression ends. |
| 3–4 Days | Cervical mucus begins to thin and become more hospitable to sperm. | Sperm can now enter the uterus more easily. |
| 7–14 Days | Ovaries may prepare to release a new egg. | High possibility of ovulation. You can get pregnant now. |
| 3–6 Weeks | First natural period typically arrives if conception hasn’t happened. | Menstrual cycle is normalizing. |
| 3 Months | Cycles should be regular for most women. | Fertility is generally back to pre-implant levels. |
| 6 Months | Full hormonal balance is usually restored. | Conception rates align with the general population. |
| 12 Months | Most couples (85%+) will have conceived. | Consult a specialist if not yet pregnant. |
How To Get Pregnant On Nexplanon – Rapid Fertility Tips
Once the rod is out, you are essentially fertile immediately. Some women ovulate within days, meaning you could get pregnant before you even see your first period. If you want to conceive right away, you do not need to wait for a cycle to pass. Doctors generally say it is safe to start trying as soon as you feel ready.
If you prefer to date your pregnancy accurately, you might wait for one normal period. This helps the doctor estimate your due date more precisely. However, there is no medical safety reason to wait. If you have unprotected sex a few days after removal, sperm can survive in your body for up to five days, waiting for that first egg to release.
Tracking Your Cycle
Because you haven’t had a real cycle in a while, predicting your first ovulation can be tricky. You won’t have a past calendar to rely on. Instead, look for physical signs. You might notice changes in your body temperature or discharge. You typically see an increase in clear, stretchy cervical mucus as fertility peaks.
You can also use ovulation predictor kits (OPKs). These test your urine for a surge in luteinizing hormone (LH), which triggers egg release. Start testing about a week after removal if you are eager to catch that first fertile window. You might even notice signs like cramps or food cravings as your ovulation cycle kicks back into gear.
Can You Get Pregnant On Nexplanon Without Removal?
While the focus here is on intentional pregnancy, some people search this topic because they fear they are already pregnant. As mentioned, the failure rate is extremely low (0.05%). However, no method is 100% perfect.
Failures usually happen because the implant was not inserted correctly or was inserted when the person was already pregnant. If the rod is palpable in your arm, it is likely working. Certain medications, like some epilepsy drugs or St. John’s Wort, can lower its effectiveness. If you take these, discuss backup methods with your doctor.
Warning Signs of Ectopic Pregnancy: If you do conceive while the implant is in, there is a slightly higher chance it could be an ectopic pregnancy. This is where the egg implants outside the uterus, usually in the fallopian tube. This is a medical emergency. Watch for:
- Severe abdominal or pelvic pain (often on one side).
- Vaginal bleeding that is heavier or different than your usual spotting.
- Shoulder pain or dizziness.
If you suspect you are pregnant with the implant, take a home test and see a doctor immediately. If positive, the implant needs to be removed, and you need an ultrasound to ensure the pregnancy is safe.
Preparing Your Body For Conception
Since fertility returns so fast, you should start preparing your body before your removal appointment. Treat the weeks leading up to the procedure as your “pre-conception” phase. This ensures that when the hormones leave your system, your body is a welcoming environment for a baby.
Start Prenatal Vitamins Early
Do not wait until the implant is out to start vitamins. Ideally, you should take folic acid for at least one month before you conceive. Folic acid prevents major birth defects of the baby’s brain and spine. Since you could get pregnant within a week of removal, having these nutrients in your system beforehand is a smart safety net.
Manage Your Health
Use the time before your appointment to check your general health. If you smoke, stopping is the single best thing you can do for fertility. Smoking can age your ovaries and deplete your eggs. Alcohol consumption should also be minimized. This is also a good time to review any other medications you take with your doctor to ensure they are pregnancy-safe.
Success Rates After Removal
You might worry that using hormonal birth control for years has “messed up” your fertility. This is a common myth. The hormones in the implant do not build up or cause long-term infertility. Once they clear, your ovaries return to their natural state.
Studies confirm that former implant users get pregnant just as easily as women who used non-hormonal methods. The return to fertility is comparable to having an IUD removed and significantly faster than stopping the shot.
Here is a breakdown of conception rates specifically for women after implant removal.
| Timeframe Post-Removal | Percentage Pregnant | Notes |
|---|---|---|
| Month 1 | ~10–15% | Some conceive before the first period arrives. |
| Month 3 | ~50% | Half of women conceive within the first quarter. |
| Month 6 | ~77% | Most couples succeed by this mark. |
| Month 12 | ~86% | Normal fertility rate for the general population. |
| Month 24 | ~92%+ | Continued efforts yield results for most. |
Common Myths About The Implant And Pregnancy
Misinformation can cause unnecessary stress when you are trying to conceive. Let’s clear up a few persistent rumors regarding getting pregnant on Nexplanon.
Myth: You need to “detox” your body.
Fact: There is no detox required. The liver metabolizes the hormones quickly. Drinking excessive water or taking herbal cleanses won’t speed this up; your body handles it naturally within days.
Myth: It causes permanent infertility.
Fact: There is no evidence that the implant causes sterility. Even if you used it for three cycles (9 years), your fertility returns to whatever your natural baseline is for your age.
Myth: You will have a miscarriage if you get pregnant too soon.
Fact: Conceiving immediately after removal does not increase the risk of miscarriage or birth defects according to ACOG standards. The uterine lining rebuilds quickly enough to support a pregnancy.
When To See A Doctor
Most women will conceive within a year of removing the implant. However, age plays a big role in fertility. If you are under 35 and have been trying for a year with no luck, it is time to see a specialist. If you are over 35, you should generally seek help after six months of trying.
Also, pay attention to your cycles once they return. If your periods are very irregular, extremely heavy, or completely absent three months after removal, consult your doctor. This might signal an underlying issue like PCOS or thyroid problems that was masked by the birth control.
Getting pregnant on Nexplanon is really about the exciting phase that comes after. The implant serves you well by being reliable, and it serves you even better by leaving your system quickly when you are ready for the next chapter. Schedule your removal, start your vitamins, and trust that your body knows what to do.