If a woman is still ovulating and having periods while on a progesterone IUD, the concern about the uterine lining not growing back after removal is less significant.

“the problem we do see in some people with progesterone iuds that maybe isn't talked about as much is that this prolonged progesterone exposure because people are putting iuds in for 5 to seven years and not having a period for that length of time because the endometrium has become so atrophic or non-existent that you're no longer bleeding despite the fact that you may be ovulating it can take a while for that lining to grow back and so it's not uncommon to have an IUD in place and if you have no period you're going to say this is great I don't have a period wonderful you get it removed and now your period hasn't come back and that leads people to sometimes be concerned that the IUD is causing them not to ovulate or they have this infertility caused by the IUD but really what it is is that the Linings become so so thin that it can take many months of that unopposed estrogen exposure in the follicular phase to get it thick enough to finally bleed when you're ovulating”

“so I do tell people if they have a progesterone IUD to get it removed 3 to 6 months before they want to get pregnant use some other form of contraception but give their body time to make sure they have that regular period pattern back”