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When it comes to birth control, the intrauterine device, also known as an IUD, is known for having one of the lowest rates of contraceptive failure. According to the experts, the chances of conceiving with an IUD is less than one percent. But if that’s the case, how did TV personality Erica Dixon end up pregnant with identical twin girls while using one?

The Love and Hip Hop alumnus announced the news late last week, noting that she was using the Mirena brand of IUD at the time she conceived. (Other common hormonal IUD brands are Skyla, Kyleena and Liletta.)

“I am pregnant. Wasn’t trying to get pregnant,” she said in a YouTube video. “This is something that, I ain’t even going to say kind of happened, but in a sense it did because I had a Mirena. Birth control to me now at this point, I’m convinced, is just the devil. It works for some people, others it doesn’t work for.”

She’s not the only one who found themselves quite confused to see a positive pregnancy test while using this particular birth control method. Singer and songwriter Terius “The-Dream” Nash announced the birth of his eighth child (he and wife Lalonne Nash’s third) and revealed that his wife was using an IUD when she conceived their daughter. Baby Maverick, to him, was “living proof IUDs might not work.

So what gives? How does one of the most effective birth control methods, which can last six years for the hormonal IUD and up to 12 years for the non-hormonal copper option, slip up like that? Especially when efforts are usually made to ensure people are good candidates for the device before it’s recommended and inserted? Stephanie Marshall Thompson, M.D., reproductive endocrinology and infertility specialist at IRMS at Saint Barnabas Medical Center in Livingston, New Jersey, said in an interview with us that while it’s rare for women to get pregnant when using it, it can happen if the device moves from where it’s supposed to be.

“Possible reasons why that can happen is migration of the IUD into the wall of the uterus or into the abdomen, which we call a uterine perforation,” she said. “It’s also possible that the IUD could have been expelled and is just no longer in the uterus or it’s not in the right place anymore. So it’s important to check the IUD string once a month to make sure that you can still feel it. Even though the IUD can move sometimes, it rarely happens, but it can happen.”

Thompson also said the risk of an IUD migrating or being completely expelled increases right after it’s inserted by your physician.

“It’s more likely for the IUD to be expelled soon after it’s put in,” she said. “Usually after you’ve had it for a while it’s generally fine, but it still can migrate and get into the wall of the uterus, or worst case scenario, into your belly or abdominal cavity.”

If you are one of the few people who end up conceiving while using the device, there are risks if it can’t be taken out early in the pregnancy.

“If you find out you’re pregnant and there is an IUD in place, if it is something easy to remove, the doctor will generally remove it. If it’s in the cervix or they have easy access to the string, they’ll usually take it out,” she said. “But if it’s farther in the uterus, or even if it’s expelled into the abdominal cavity, then it’s just left alone until the baby is born. So that’s why sometimes you’ll see people will have a picture with the baby holding the IUD [laughs]. But it does pose some risks. Risk of miscarriage, risk of preterm delivery and risk of amniotic fluid, amniotic sac rupture. But there’s really nothing to do besides monitor the pregnancy very closely.”

It’s easy to hear about Dixon and Lalonne Nash’s situations and think birth control is a joke. But again, it truly is a rarity that one conceives while using an IUD, not to mention, it’s not the perfect device for every woman’s uterus in the first place.

“Things like an IUD are generally supposed to be very user-friendly because there should be nothing else for you to do,” she said. “It is important to asses risk factors for the IUD coming out. For example, if somebody has a uterus that is not shaped normally or there’s a fibroid or has a difficult placement of the IUD, those things are important before you even talk to your doctor about getting one. So it’s really important to assess the patient properly for an IUD because it is a physical barrier. It’s not like taking a pill.”

If you want to consider another option, there are other methods of birth control that are also lauded for their effectiveness — if used correctly by you, the user.

“The other forms of contraception are user dependent, like the birth control pill and the NuvaRing. So it really depends on the user,” she said. “When used properly, they have, again, very, very low failure rates, but they have to be used properly.”

Still, she would definitely recommend the IUD.

“An IUD has the least amount of contraceptive failure compared to other methods of birth control,” she said. “All forms of birth control that are available, with the exception of the rhythm method, are generally highly successful, but many of them again are user dependent. The reasons for failing each form of contraception depends on what it is. Reasons for an IUD expulsion or failure, although those are rare, sometimes can be anatomic or placement of the IUD, so that’s why it is important to be a good candidate for an IUD. Depo-Provera has a low failure rate, but it has other associated symptoms like weight gain. It also requires you coming in for a regular injection. The birth control pill and the NuvaRing do too, but again, they’re user dependent. I think anything that takes it out of the hands of the user of having to remember something daily is going to give you a lower failure rate overall.”

Obviously, one takes birth control to keep themselves from having a child, so while an IUD failure may be a rarity, as Thompson put it, it’s real, and it’s real frustrating. Still, hormone-releasing IUDs are not all a loss. They are 99 percent effective and tend to be a lot more convenient than other methods. But with all things birth control-related, it’s best to speak with your doctor first to find out what the best method is for you.


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