Does Taking Suboxone Make It Hard to Get Pregnant?

Opioid drugs, including prescription painkillers and illicit drugs can impair fertility in both women and men.[1]  However, Suboxone carries a lower risk of any fertility issues, and is generally thought to be very safe to take both while trying to conceive and while actually pregnant.  Especially if you are recovering from an OUD, the risks of infertility are extremely low and are likely outweighed by the benefits of continuing your treatment, particularly in preparation for becoming a new mother. 

What Is Suboxone?

Suboxone is a prescription medication doctors use to address OUD in both men and women. 

Each dose of Suboxone contains two ingredients: buprenorphine and naloxone. Buprenorphine treats withdrawal symptoms and drug cravings, while naloxone prevents misuse. 

Suboxone is safe to use during pregnancy and while trying to conceive. Medication for Addiction Treatment (MAT) programs using drugs like this are recommended for women struggling with OUD during pregnancy.[2] Suboxone has not been shown to significantly affect fertility in any way. Plenty of women get pregnant while taking Suboxone and continue this medication safely throughout their pregnancy. 

Suboxone’s Effect on Your Body 

For people with OUD, cravings and uncomfortable withdrawal symptoms can lead them back to illicit drug use. Suboxone can ease those cravings and soothe withdrawal discomfort, so people can focus on building healthier lives.

Researchers performing studies with mice found that buprenorphine could damage sperm cells and impact male fertility although this has NOT been shown to be true in humans. [3] If a man is trying to get a partner pregnant, he can safely continue Suboxone. As far as we know, Suboxone does not decrease sperm count or fertility in men. 

Fewer studies on female fertility exist specifically looking at Suboxone and fertility. What I do know is that there are some studies that suggest that use of opioid pills and other illicit opioids like heroin or fentanyl do potentially reduce the ability to get pregnant. Women using opioids had a 29% lower chance of getting pregnant, and those who did get pregnant were 1.5 times more likely to miscarry than those who did not.[4] Therefore, is Suboxone helps you to abstain from full opioid use, it may even improve your chances of stabilizing and getting pregnant. 

Opioid Use Disorder & Pregnancy 

Pregnant women share many of their foods, drinks, and medications with their babies. Substances pass from a mother’s body to her baby through the umbilical cord, and sometimes, that sharing can cause significant harm.

Continued use of opioids like heroin during pregnancy can lead to the following:[5]

• Death of the mother 
• Low birth weight of the baby 
• Early birth
• Stillbirth 
• Birth defects 

Some babies born to moms with OUD develop neonatal abstinence syndrome (NAS). These babies develop a physical dependence on opioids in the womb, and their supply is cut off at birth. They develop flu-like withdrawal symptoms, and since they have diarrhea and irritation, they don’t grow well. 

Suboxone may cause mild withdrawal symptoms in your baby after delivery, but they are usually much more mild than full opioids like painkiller pills or illicit opioids like heroin or fentanyl, and therefore Suboxone is considered much safer in pregnancy than full opioids both for mom and baby. 

What to Consider When You’re Pregnant 

If you’re living with OUD, getting pregnant can be both an exciting and a stressful experience. Before you consider quitting your treatment cold turkey, know that your doctor can help you stay on medications like Suboxone safely during your pregnancy, eliminating the risk of relapse or return to opioid use. 

Officials recommend that women with OUD use medications during pregnancy instead of trying to quit cold turkey.[2] 

Medications like Suboxone can treat physical dependence in both you and your baby. And when your doctor knows your baby has been exposed to buprenorphine, you can plan for an after-birth treatment plan to ease your baby through the mild NAS symptoms that might appear. 

Your participation in treatment can help you prepare for your baby’s birth. Counseling can support you as you become a new mother. 

Suboxone Alternatives for Pregnant Women 

Both Suboxone and Methadone can be taken during pregnancy. 

Medications containing buprenorphine (like Suboxone) are associated with slightly higher birth weights and better outcomes for babies when compared to methadone.[6] But Suboxone medication isn’t right for everyone.

If you’re accustomed to taking strong drugs like fentanyl, Suboxone may not be strong enough for you. Some people also prefer supervision while taking their medication, as they’re tempted to attempt to misuse take-home drugs like buprenorphine. For these individuals, a daily methadone program might be appropriate.

Just remember that it’s critical to treat OUD during pregnancy. Reach out to your doctor if you are on Suboxone and are either pregnant or trying to become pregnant. 

Sources

1. Suboxone Prescribing Information. U.S. Food and Drug Administration. https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2017/08/opioid-use-and-opioid-use-disorder-in-pregnancy. March 2021. Accessed January 2023. 
2. Opioid Use and Opioid Use Disorder in Pregnancy. American College of Obstetricians and Gynecologists. https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2017/08/opioid-use-and-opioid-use-disorder-in-pregnancy. August 2017. Accessed January 2023. 
3. The Effects of Long-Term Administration of Buprenorphine on Blood Testosterone Level and Morphometrical and Histological Changes of Mouse Testis. Comparative Clinical Pathology. https://www.researchgate.net/publication/251418994_The_effects_of_long-term_administration_of_buprenorphine_on_blood_testosterone_level_and_morphometrical_and_histological_changes_of_mouse_testis. December 2011. Accessed January 2023. 
4. NIH Study Suggests Opioid Use Linked to Pregnancy Loss, Lower Chance of Conception. National Institutes of Health. https://www.nih.gov/news-events/news-releases/nih-study-suggests-opioid-use-linked-pregnancy-loss-lower-chance-conception. August 2020. Accessed January 2023. 
5. About Opioid Use During Pregnancy. Centers for Disease Control and Prevention. https://www.cdc.gov/pregnancy/opioids/basics.html. November 2022. Accessed January 2023. 
6. Buprenorphine Compared with Methadone in Pregnancy: A Systematic Review and Meta-Analysis. Substance Use and Misuse. https://www.tandfonline.com/doi/full/10.1080/10826084.2022.2083174. June 2022. Accessed January 2023.