For numerous uterus owners using birth control, the end goal is the same: to stop conception and pregnancy. Yet just since the final destination is the exact same doesn’t average that every reversible birth regulate methods (i.e., the techniques that don’t involve operation removal that reproductive organs) take the same route to obtain there.

Over the critical 60-ish years, scientists have harnessed our knowledge of the various steps vital to develop a pregnant to develop powerful, reliable methods of birth manage — not every one of which occupational in specifically the same way.

In this post, we’ll walk over the similarities and differences in how various popular birth regulate methods work-related to stop pregnancy. Us will also specifically define how birth manage impacts even if it is or not you ovulate.

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Conception 101: What needs to happen?

To understand how different birth control methods work, we need to first understand the chain of occasions that is forced for conception come occur. Though there space seemingly boundless things that should go ideal for a pregnancy to it is in established, there are three main obstacles that a sperm and egg need to overcome (and these space all non-negotiable!):

Sperm meets egg: Sperm require to gain past the cervix, come then proceed making their method through the uterus and also eventually come the fallopian tube and also egg. If an egg isn’t roughly when sperm acquire there, that’s okay as well — sperm deserve to survive as much as 5 job in the female reproductive tract.

Substantial snags in any single step, or in many steps, do conception a totality lot harder. Think about it favor an problem course: To acquire from the begin to the end up line (where the complete line is acquiring pregnant), you require to acquire past each and every hurdle. Birth regulate works by making number of of these obstacles practically impossible come overcome.

How go your birth control an approach work?

Before we begin nerding out about the science behind the pregnancy-blocking obstacles various birth control methods introduce, here’s a quick summary of how your current birth control technique may work.

Prevents ovulationThickens cervical mucusThins uterine lining% of civilization pregnant in 1 year
Combined oral contraceptive7%
Minipill❌ for 60% the cycles✅ for 40% the cycles7%
Copper IUD0.8%
Low-dose hormonal IUDs (Mirena & Liletta)❌ because that 45% - 75% of cycles✅ for 25 - 55% of cycles0.4%
Lower-dose hormone IUDs (Kyleena & Skyla)❌ for 88% - 97% that cycles✅ for 3% - 12% the cycles0.4%

Table note: typical use failure prices from the CDC. Resource for added data points: Mirena, Liletta, Kyleena, Skyla, Copper IUD. Copper IUDs space a bit of an outlier in that copper ions released native the implant develop a local, non-dangerous inflammatory an answer that provides the uterus toxicity for sperm (think the it together sperm-neutralizing).


Birth control-induced obstacle #1: avoiding ovulation

The majority of reversible hormonal birth control methods occupational by preventing ovulation. To understand exactly how this happens, we turn earlier to our knowledge of the straightforward physiology the underlies ovarian follicular advancement and ovulation.

Here we’ll describe how estradiol, luteinizing hormone (LH), and also progesterone levels all fluctuate — and also what tracking every of this hormones have the right to tell you about ovulation.
Talia ShiraziModern Fertility Blog


The reproductive hormone production chain starts turn off in her brain: The hypothalamus signal the pituitary to release follicle-stimulating hormone (FSH) and luteinizing hormone (LH).

As the surname implies, FSH facilitates the development and mature of follicles that home eggs, and also LH is the hormone that coaxes emerged eggs to be released from follicles and into the fallopian tube (aka ovulation), where it deserve to potentially meet up through sperm. Some estradiol and progesterone, developed by both developing and ruptured follicles, do their way to the mind where they tell it come chill top top its production of both FSH and LH. In techniques of birth control that release fabricated hormones comparable to estradiol and progesterone right into your bloodstream, we watch a similar thing happen — level of this hormones are continuously high sufficient to inhibit the production and also release the FSH and FSH. And also if there’s no follicular development, and nothing to stimulate the release of eggs from follicles, there’s no ovulation.

Caveat: no all efficient methods of hormonal birth control constantly prevent ovulation (we’re looking in ~ you, minipill and hormonal IUDs). Despite both the these techniques contain progestins i m sorry do do it to the mind and inhibit some of the production and also release of FSH and also LH, the progestin doses are low enough that in part cases, FSH and LH level aren’t suppressed sufficient to continuously inhibit follicular development and ovulation.

This is particularly true in the instance of hormone IUDs, where most of the progestin released acts on physiological structures in its instant vicinity, and also only tiny amounts make their way into the bloodstream and also to the brain. Why ovulation is impaired in just some customers or just in some cycles is quiet a mystery, and also we aren’t however able to predict that will or will not proceed ovulating when using the minipill or hormone IUD.


Birth control-induced obstacle #2: Thickening cervical mucus

Cervical mucus closely tracks hormone levels — much more specifically, estradiol and progesterone levels — and also this tracking is for this reason close that many people with ovaries monitor your cervical mucus to estimate whether they’re in their fertile window (aka when the possibilities for conception room highest).

High estradiol and low progesterone, which is characteristic of the abundant window, brings about a special type of cervical rubber (slippery, clear, stretchy “egg white” cervical mucus) that actually helps sperm acquire past the cervix and also to the egg (assuming one was released throughout ovulation), thereby making conception much more likely. Any type of birth regulate that raises progesterone or lowers estradiol will make it yes, really tricky (and by that, we mean virtually impossible) because that sperm to do it past the cervix and any closer to an egg. Bottom line? This way that if you room on a form of birth control that thickens your cervical mucus, you must never be seeing that slippery, clear, stretchy “egg white” mucus.


Birth control-induced obstacle #3: avoiding endometrial thickening

If because that some factor something goes awry and also some sperm do it previous the cervix and to the uterus, every reversible birth manage methods have your back with a an effective backup plan. For a fertilized egg to develop and also grow, it requirements to collection up shop in the uterine lining, which later offers rise come structures prefer the placenta which are *crucial* for its development.

In usual menstrual cycles without hormonal birth control, progesterone and estradiol thicken the uterine lining and make it much more receptive to, and nourishing for, a fertilized egg. Hormonal birth regulate methods job-related by managing the quantity of progesterone (and sometimes estradiol) — make the uterine lining also thin and undeveloped for successful implantation and also pregnancy (think of this like expanding the state the uterine lining is in best after you end up your period).

Because birth regulate methods space extremely effective at preventing an egg from gift fertilized in the first place (via obstacles #1 and also #2 as debated above), this endometrial-thinning-backup-plan doesn’t need to obtain used all the often. But even if in which method an egg does acquire fertilized if you’re on bear control, this alone doesn’t add up come a pregnancy; the American university of Obstetricians and Gynecologists and also other reproductive health organizations have characterized a pregnant as beginning once a fertilized egg implants right into the uterine lining.

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The special instance of copper IUDs: In the situation of copper IUDs, copper ions released indigenous the implant create a local, non-dangerous inflammatory an answer that makes the uterus toxic for sperm (think that it as sperm-neutralizing). The inflammatory response caused by the visibility of the copper ions provides it harder for sperm to make their method around, and additionally makes the uterine lining less hospitable come a optimistic fertilized egg. For this reason while the copper IUD doesn’t avoid the thickening the the uterine lining (which is why most copper IUD users will proceed to get regular periods!), the does induce other transforms in the uterus that make that a not-conception-friendly place to be.

To ovulate or not to ovulate? A an individual preference

You can be wondering: If many reversible birth regulate methods readjust cervical mucus and the uterine lining, what room the pros/cons to choosing a birth control an approach that also suppresses ovulation? ~ all, the birth control methods that always suppress ovulation are not an ext effective 보다 those the don’t, when you look at at common use success/failure rates.

This an option ultimately comes down to what your personal preference is. Suppressing ovulation by birth regulate is no “bad” or “good.” What we typical by that: There’s no scientific evidence that not ovulating now will make it harder to ovulate later — yet it likewise won’t “save” eggs and also leave you more later in life. Though usually one egg is released from one follicle during ovulation, somewhere between 800 and 1,000 follicles naturally die off each month (regardless of even if it is you room on birth control or ovulating) through a natural procedure called “apoptosis” — which makes the one egg you’d possibly “save” every month while being on ovulation-suppressing birth control seem nice inconsequential in comparison.