Does taking Suboxone make it hard to get pregnant?

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No, taking buprenorphine/naloxone (Suboxone) can improve fertility and may result in an unplanned pregnancy. 

Opioid use disorder and pregnancy 

Long-term use and misuse of opioids can lead to infertility problems such as erectile dysfunction, decreased sperm motility, menstrual disorders, and loss of menstruation. 

Opioid use in pregnancy has also increased and become a significant problem for birthing individuals and their babies within the United States. 

Neonatal abstinence syndrome (NAS) is the drug withdrawal syndrome that infants exposed to opioids experience shortly after birth. Today, approximately one infant is born every 30 minutes with drug withdrawal. 

Therefore, if a birthing person with opioid use disorder (OUD) is interested in becoming pregnant or is pregnant, the standard of care includes starting them on Medication for Addiction Treatment (MAT) with either methadone or buprenorphine

It is not recommended for pregnant people with OUD to taper off opioids (or go through withdrawal) due to the risk of decreased infant birth weight, illegal drug use relapse, and resumption of high-risk behaviors (e.g., intravenous drug use). 

Pregnancy considerations while taking buprenorphine 

The use of buprenorphine may improve fertility, and therefore, an unplanned pregnancy can occur in sexually active people.  

MAT treatment is most effective when combined with counseling or behavioral therapy. In addition, birthing people stabilized on MAT have a lower risk of opioid withdrawal and illegal drug use relapse. 

For many years, methadone was the preferred agent for OUD treatment in pregnancy. However, recent evidence supports the use of buprenorphine during pregnancy since it is less likely to cause an overdose, has fewer drug interactions and can be given on an outpatient basis with fewer dose adjustments.  

Buprenorphine is available by itself (monotherapy) or in combination with naloxone (Suboxone). The monotherapy buprenorphine product has historically been used in pregnancy, but recent evidence suggests that the combination product Suboxone can also be safely used with similar outcomes. 

If you are currently on MAT, it is crucial that you do not change your MAT medicine without speaking to your MAT provider. If you have questions or concerns, please consult your MAT provider first.

Brittany Hoffmann-Eubanks, PharmD, MBA

Brittany Hoffmann-Eubanks, PharmD, MBA, received her Doctor of Pharmacy and Master of Business Administration degrees from Drake University College of Pharmacy and Health Sciences and completed her community pharmacy residency with Midwestern University and a local community pharmacy.

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