Intrauterine devices and subdermal implants work by continuously delivering hormones or, in the case of copper IUDs, by altering the uterine environment. Neither of these is compatible with the controlled hormone stimulation protocol used in egg donation. Before your cycle starts, your birth control device will need to come out. This is routine, well-understood, and doesn’t affect your long-term eligibility. But the timing matters, and it’s something you’ll want to plan for before you apply.
Here’s exactly what egg banks require for IUD and Nexplanon donors, how the removal timeline works, and what the donation process looks like once you’re cleared to proceed.
Why IUDs and Implants Need to Come Out
Egg donation requires the medical team to take precise control of your hormonal environment. The stimulation protocol uses carefully calibrated injections to push your ovaries to produce multiple follicles within a tightly managed timeframe. Any device that is independently influencing your hormone levels or uterine function creates variables the protocol can’t account for.
Hormonal IUDs (Mirena, Kyleena, Liletta, Skyla) release a steady low dose of levonorgestrel locally. Nexplanon releases etonogestrel continuously into the bloodstream. Both suppress or alter normal ovarian function to varying degrees. Running a stimulation cycle on top of either device is clinically problematic.
Copper IUDs (Paragard) are non-hormonal, so they don’t interfere with ovarian stimulation directly. But they do affect the uterine environment, and their presence during a medically supervised cycle involving hormone injections and close monitoring raises practical and clinical complications. Removal is still required.
You can donate eggs with an IUD or Nexplanon — but not while the device is in place. Removal is required before your stimulation cycle begins. After removal, a waiting period allows your natural cycle to re-establish before the team begins monitoring. This adds time to your overall timeline but does not close the door on donation permanently.
Hormonal IUDs: Mirena, Kyleena, Liletta, Skyla
These devices work by releasing levonorgestrel, a synthetic progestin, directly into the uterus. The hormone suppresses the endometrium and alters cervical mucus, and in many users it partially or fully suppresses ovulation.
Because levonorgestrel directly affects the hormonal environment that egg donation relies on, removal before stimulation is non-negotiable. After removal, your body needs time to clear the residual hormonal effect and re-establish a natural cycle pattern. Most egg banks require at least one natural menstrual cycle following hormonal IUD removal before monitoring can begin.
ACOG notes that fertility typically returns quickly after hormonal IUD removal, often within the first cycle. For egg donation purposes, it’s not just fertility returning. It’s the predictability of your cycle pattern that the medical team needs before they can plan your stimulation.
Nexplanon: The Arm Implant
Nexplanon is a small rod inserted under the skin of the upper arm that releases etonogestrel into the bloodstream. Unlike hormonal IUDs, which act mostly locally, Nexplanon has a systemic effect. It reliably suppresses ovulation in most users.
Nexplanon’s FDA prescribing information confirms it reliably suppresses ovulation in most users through continuous systemic etonogestrel release. For egg donation, this is the most significant of the long-acting reversible contraceptives (LARCs) from a protocol standpoint. Systemic progestin suppression directly conflicts with the stimulation protocol.
Removal is required, and the waiting period after Nexplanon removal may be slightly longer than for hormonal IUDs, as the systemic hormone needs to clear before a reliable baseline cycle can be established.
If you’re considering egg donation and currently have Nexplanon or an IUD, you don’t need to remove it before applying. Apply first and discuss the timeline with your coordinator. Removal is coordinated as part of the pre-cycle preparation. You won’t be asked to manage it on your own before you’ve even started the process.
The Copper IUD: Paragard
Paragard is non-hormonal. It works by creating a copper ion environment in the uterus that is toxic to sperm, without affecting estrogen or progesterone levels. Many donors assume this means it doesn’t need to be removed.
It does. According to ACOG’s guidance on long-acting contraceptives, fertility returns promptly after copper IUD removal. But the uterus plays no role in egg retrieval itself. Eggs are retrieved directly from the ovaries via transvaginal aspiration. The presence of a foreign device during a medically supervised cycle still introduces complications that egg banks are not set up to manage.
The practical difference for Paragard users is that the post-removal waiting period is typically shorter. Because there’s no hormonal component to clear, your natural cycle should re-establish more quickly after removal. Many programs require just one confirmed natural cycle before proceeding.
The Removal and Waiting Period Timeline
The full timeline from device removal to the start of your stimulation cycle depends on which device you have and how quickly your natural cycle re-establishes.
Removal: Simple in-office procedure, usually takes a few minutes.
Waiting period: Typically 1–2 natural cycles before stimulation can begin.
Removal: Minor in-office procedure under local anesthetic. Takes about 10 minutes.
Waiting period: Typically 2–3 natural cycles to allow systemic hormone clearance.
Removal: Simple in-office procedure, usually takes a few minutes.
Waiting period: Typically 1 natural cycle, since there’s no hormonal component to clear.
These are general timeframes. IUD removal is quick and typically takes just a few minutes in a clinical setting. Your specific coordinator will confirm the requirements based on which device you have, how long you’ve had it, and your cycle history. Your fertility specialist will make the final call on when your baseline is ready to proceed.
How This Differs From Other Birth Control Methods
Long-acting devices like IUDs and Nexplanon require removal and a waiting period. Shorter-acting hormonal methods are handled differently.
The pill, patch, and ring all deliver hormones that clear from your system within days of stopping. Most egg donation programs can begin cycle planning after just one natural period following discontinuation of short-acting hormonal contraceptives. Our full birth control and egg donation guide covers how different methods are handled from the pill through to hormonal injections.
Tubal ligation is a separate question entirely. If you’ve had your tubes tied, the tubes play no role in egg retrieval. Eggs are retrieved directly from the ovaries. Our tubes tied and egg donation guide explains why this is generally not a disqualifier. Similarly, if you’ve had a hysterectomy, our hysterectomy and egg donation guide covers the ovarian function question specifically.
What the Full Donation Process Looks Like
Once your device is removed and your cycle has re-established, the donation process follows the standard timeline. Here’s what to expect.
Disclose your current contraception in the application. Your coordinator will discuss the removal and waiting period timeline with you once you’re accepted.
Your IUD or implant is removed by your own provider or at a clinic arranged through your coordinator. Removal costs are covered as part of your donor medical expenses.
1–3 natural cycles depending on the device. Medical screening continues during this period so nothing is delayed once your cycle baseline is confirmed.
Blood work, hormone levels, ovarian reserve assessment, genetic testing, infectious disease screening, and physical exam. All costs covered by Lucina.
10–14 days of self-administered hormone injections, monitored closely with blood tests and ultrasounds at our San Diego clinic to track follicle development.
A minor outpatient procedure under light sedation. About 15 minutes. Standard donors earn $8,000–$15,000+ per cycle. Iconic donors from top-ranked universities earn up to $50,000.
The full egg retrieval process is explained in detail in our egg retrieval process guide, including what the monitoring appointments involve and what to expect on retrieval day.
The best way to understand exactly how your current contraception affects your donation timeline is to apply and discuss it with your coordinator directly. Our egg donor screening guide also explains what the medical team looks at during baseline evaluation.
Start Your ApplicationAn IUD Is a Timeline Question, Not an Eligibility One
The most important thing to understand is that having an IUD or Nexplanon is a scheduling consideration, not a reason to assume you can’t donate. Thousands of women use long-acting contraceptives. The fact that you need to remove yours before donating is a known, routine step. Not a red flag, not a complication, and not something that affects your medical eligibility beyond the timing itself.
If you’re otherwise a good candidate, age 19–31, healthy, with no disqualifying conditions, an IUD or Nexplanon just means your start date gets pushed by a few cycles. The egg donor disqualifier guide covers what actually rules people out. A LARC is not on that list.
Standard donors at Lucina earn $8,000–$15,000+ per cycle, with Iconic donors from top-ranked universities earning up to $50,000 per cycle. All medical costs including device removal are covered, and the full process from application to retrieval takes 6–10 weeks once your cycle baseline is confirmed.
Apply to Donate Eggs With Lucina
The application takes 15 minutes. Disclose your current contraception and let the team walk you through the removal and timing process. All medical costs including device removal are covered.
$8,000–$15,000+ per cycle (Standard) · Up to $50,000 per cycle (Iconic) · 6–10 week process
All medical and travel costs covered. Compensation paid after retrieval. Up to 6 donation cycles allowed per ASRM lifetime guidelines.
Frequently Asked Questions
Julianna Nikolic
Chief Strategy Officer Julianna Nikolic leads strategic initiatives, focusing on growth, innovation, and patient-centered solutions in the reproductive sciences sector. With 26+ years of management experience and a strong entrepreneurial background, she brings deep expertise to advancing reproductive healthcare.
Table of Contents
- Why IUDs and Implants Need to Come Out
- Hormonal IUDs: Mirena, Kyleena, Liletta, Skyla
- Nexplanon: The Arm Implant
- The Copper IUD: Paragard
- The Removal and Waiting Period Timeline
- How This Differs From Other Birth Control Methods
- What the Full Donation Process Looks Like
- An IUD Is a Timeline Question, Not an Eligibility One
- Frequently Asked Questions
