Does Birth Control Affect Fertility? What to Know if You’ve Been on BC for Years

Many women spend years, even decades, on hormonal birth control — and it is natural to wonder what impact that might have on fertility. The reassuring news is that hormonal contraception does not harm your long-term fertility. It does not deplete your ovarian reserve or cause permanent changes to your ability to conceive.

How Does Birth Control Affect Your Cycle?
Birth control can mask underlying fertility-related issues that would otherwise show up in your cycle or hormone patterns. While you are using hormonal contraception, key reproductive hormones such as FSH, LH, estradiol, and progesterone are suppressed, which means ovulation is paused and cycle tracking is not possible. Conditions like PCOS, thyroid dysfunction, or low ovarian reserve may go unnoticed while on birth control, only to emerge after discontinuation.

When Does Fertility Return After Stopping Birth Control?
Fertility generally returns quickly once you stop using birth control. For most women, cycles and ovulation resume within one to three months. For others, particularly after long-term use, it can take six to twelve months for cycles to fully regulate.

What Can You Test While on Birth Control?
The good news is that there are important aspects of fertility and reproductive health that you can assess even while on birth control. Anti-Müllerian Hormone (AMH) remains a valid marker of ovarian reserve and can provide insight into whether egg freezing or other proactive steps might make sense for you. Metabolic and thyroid markers — such as TSH, HbA1c, Vitamin D, and markers of inflammation — remain informative and can be optimized now. Certain signs of PCOS, such as elevated testosterone or DHEAS levels, can also be detected through blood testing while using birth control.

Why a Proactive Approach Matters
If you have been on birth control for years, it is wise to take a proactive approach to fertility health. Understanding your ovarian reserve, screening for hidden metabolic or hormonal issues, and developing a personalized plan for what to test now versus after discontinuing birth control can set you up for success when the time is right.

At Rita, we guide women through this process — helping you understand what you can safely test now, what may require follow-up later, and how to interpret these results in the context of your personal fertility goals. Birth control gives you options. We help you protect and expand them.