Pregnancy On The Coil: Can It Happen?

The coil is a popular contraceptive device. Its proper name is not quite as catchy, it’s the IUD, which stands for intrauterine device. The coil is a common and effective contraceptive method used by loads of women in the UK. Big question: can you still get pregnant while using the coil?

What Is the Coil?

The coil is a tiny, T-shaped device made of copper and plastic that is inserted into the uterus by a trained doctor or nurse. It works by releasing copper, which affects sperm and helps prevent an egg from being fertilised.

Once fitted, the coil can remain in place and provide continuous contraceptive protection for 5-10 years, depending on the type. Some devices are licensed for different durations, so check which coil you have and when it needs replacing. The NHS says it can be fitted at any point during your menstrual cycle, as long as you are not already pregnant.

The term “coil” can also be used for the hormonal intrauterine system (IUS). This article focuses on the copper IUD, which does not release hormones.

How Does the Coil Prevent Pregnancy?

The presence of the coil and copper changes the environment inside the uterus, which prevents pregnancy in a few key ways:

• The copper affects sperm and reduces their ability to move and fertilise an egg.
• It creates an environment in the uterus that makes fertilisation very unlikely.
• Unlike the hormonal IUS, the copper coil does not work primarily by thickening cervical mucus or thinning the uterine lining.

The coil does not protect against sexually transmitted infections (STIs), so additional protection such as condoms may be needed.

How Effective Is the Coil?

The coil is over 99% effective at preventing pregnancy, according to the NHS. This makes it one of the most reliable reversible methods of contraception available.

However, it is still possible, but rare, for pregnancy to occur with the coil in place. This can happen if the device moves out of position, gets expelled from the uterus, or was not fitted properly in the first place.

While the coil is highly effective, it’s crucial to understand that no contraceptive method is 100% foolproof. If you’re using the coil and suspect you might be pregnant, look out for early signs like missed periods, breast tenderness or nausea. Taking a home pregnancy test is a good first step, but remember that false negatives can occur early on.

If you get a positive pregnancy test while using a coil, seek prompt medical advice. A healthcare professional can assess the pregnancy, check the coil and arrange any necessary investigations. Do not try to remove the coil yourself.

Pregnancy with a coil is uncommon, but when pregnancy does occur, there is a greater chance that it could be ectopic compared with pregnancies occurring without contraception. The overall risk of ectopic pregnancy remains low because the coil prevents most pregnancies. Seek urgent medical help if you have severe or one-sided lower abdominal pain, shoulder-tip pain, dizziness, fainting or heavy bleeding. These symptoms need assessment even if a home pregnancy test is negative.

Checking Your Coil Is in Place

You can check your coil is still in place by feeling for the thin threads that hang down through the cervix into the vagina. Your nurse will show you how to do this after fitting.

It’s recommended to check regularly, particularly during the first few months after fitting. Follow the instructions given by the healthcare professional who fitted your coil.

If you cannot locate the threads, or they feel different from usual, your coil may have moved and you may not be protected against pregnancy. Use condoms or avoid sex until a healthcare professional has checked the coil. Contact your GP or sexual health clinic promptly. If you have recently had sex without additional contraception, ask whether emergency contraception is needed. Do not pull on the threads yourself.

The Benefits of the Coil

There are many advantages to using the coil as your contraceptive method:

• It is over 99% effective and provides very reliable long-term protection.
• Once fitted, you do not have to remember to take or use anything for up to 5-10 years, depending on the device.
• Its effectiveness is not generally affected by other medicines you might be taking.
• Normal fertility returns very quickly after removal.
• It does not interrupt sex.
• There are no hormonal side effects from the copper coil because it does not release hormones.
• It is safe to use when breastfeeding.

The Potential Disadvantages

There are a few things to be aware of when using the coil:

• Periods may get heavier, longer or more painful, especially in the first 3-6 months. This may improve over time, although some people continue to experience heavier periods.
• It does not protect against STIs, so additional protection may be required.
• There is a small chance of getting an infection or damage to the womb during fitting.
• There is a risk of the coil being expelled from the uterus or moving position.

What Are the Risks?

As with any medical procedure, there are some small risks to be aware of:

• Pelvic infection: There is a small risk of infection, particularly during the first few weeks after fitting.
• Expulsion: Uncommon, but the coil can be pushed out of the womb, sometimes without you noticing.
• Uterine perforation: There is a very small chance of damage to the uterus during fitting.
• Ectopic pregnancy: Pregnancy is rare with a coil, but any pregnancy that occurs needs prompt assessment to rule out an ectopic pregnancy.
• Changes to periods: Periods may become heavier and more painful, particularly initially.

Contact a healthcare professional if you develop persistent lower abdominal pain, a fever, unusual vaginal discharge or other concerning symptoms after fitting.

Getting Your Coil Removed

Only a trained doctor or nurse should remove your coil, if and when you decide you want it taken out. You will need to book an appointment for this quick procedure. Fertility returns to normal very quickly afterwards.

If you do not want to become pregnant, ask about alternative contraception before removal. You may need to use another method, such as condoms, for seven days beforehand.

In Summary

The coil is a highly effective long-acting reversible contraceptive that provides excellent protection against pregnancy for 5-10 years, depending on the device. While rare, pregnancy can still happen if the coil moves out of place or is expelled.

Checking your coil is in the right position is important. Be aware of the small risks, but for most women the coil is safe and very reliable. If you suspect pregnancy while using a coil, take a pregnancy test and seek prompt medical advice if the result is positive. Do not ignore symptoms that could indicate an ectopic pregnancy.

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