If you get pregnant with an IUD, it’s uncommon, but it needs prompt medical attention because there’s a higher risk of ectopic pregnancy and other complications. A clinician will usually confirm where the pregnancy is and often try to remove the IUD early if it’s safe to do so.

What can happen

  • Pregnancy can still occur with an IUD, though it is very rare, with less than 1% of users getting pregnant each year.
  • One of the biggest concerns is ectopic pregnancy, where the pregnancy implants outside the uterus.
  • If the pregnancy is in the uterus and the IUD stays in place, the risks of miscarriage, early birth, and infection are higher.
  • If the strings are accessible, a doctor may remove the IUD; if not, imaging may be used to locate it first.

What to do next

  1. Take a pregnancy test if you think you might be pregnant.
  2. Contact a doctor or urgent care promptly if the test is positive.
  3. Seek emergency care right away for severe one-sided pain, shoulder pain, fainting, or heavy bleeding, since those can be warning signs of ectopic pregnancy.
  1. Do not try to remove the IUD yourself.

Why it matters

A pregnancy with an IUD is not something to “watch and wait” on at home. Early evaluation helps determine whether the pregnancy is ectopic, whether the IUD can be removed, and what the safest next steps are.

TL;DR

Pregnancy with an IUD is rare but serious enough to check quickly. The main concern is ectopic pregnancy, and a clinician should evaluate it as soon as possible.

If you have pain or bleeding right now, should I help you think through whether it sounds urgent?