How long after Accutane can you get pregnant?

What does the evidence say about how long to wait after accutane before pregnancy during pregnancy?

1. Isotretinoin clears most healthy adults' bodies within about six days on average, and the recommended wait before trying to conceive is a full month after the last dose. 1
2. If pregnancy occurs while isotretinoin is still in a person's system, published rates run as high as a 40% chance of miscarriage and birth defects in 35% or more of exposed infants, including malformed or absent ears, hearing and vision problems, and heart defects. 1
3. The iPLEDGE program requires two negative pregnancy tests before the first prescription is filled, then monthly pregnancy testing and a monthly visit with the prescribing provider for as long as the prescription continues. 2
4. Retinoids taken by mouth, the category isotretinoin belongs to, are established to cause birth defects, which is the foundational reason behind iPLEDGE's strict testing and contraception requirements. 3
5. Oral retinoid medications carry a clear, established link to congenital malformations, making them contraindicated throughout pregnancy regardless of dose or timing. 4

Is how long to wait after accutane before pregnancy safe in each trimester?

• First trimester. This is the waiting period itself. Isotretinoin clears the body within about six days on average, but the recommended wait before trying to conceive is a full month after your last dose, with two forms of birth control continuing the whole time. There's no evidence of a lasting fertility effect, just this window to respect.
• Second trimester. If pregnancy happens anyway while isotretinoin is still in your system, doctors consider this a high-risk exposure. Reported rates run as high as 40% for miscarriage and 35% or more for birth defects affecting the ears, eyes, heart, and other structures. Contact your prescriber and obstetric provider right away rather than waiting for a scheduled visit.
• Third trimester. Once you're past the one-month mark with a negative pregnancy test, there's no evidence the drug lingers or affects a future pregnancy. Normal preconception steps, like starting folic acid, apply from here just as they would for anyone else trying to conceive.

Isotretinoin's iPLEDGE timeline