Feeling pukey isn’t just for pregnant people who don’t have an IUD, Dr. Huma Farid, an OB-GYN at Harvard Medical School and Beth Israel Deaconess Medical Center, tells Romper. In fact, you can expect to experience the same pregnancy symptoms as any other woman. “Women may experience signs of pregnancy, such as breast tenderness, morning sickness, fatigue,” explains Dr. Farid. And while your nausea could be attributed to that big breakfast burrito you just ate, if you keep having consistent nausea (especially in the morning), and think you could possibly be pregnant with an IUD inserted, you should contact your doctor right away.

If you have an IUD, then you know some of its less-than-thrilling side effects, the biggest one of which is bleeding. And if your IUD is copper, it can cause heavy bleeding, as was found in the study, “Side effects from the copper IUD: do they decrease over time?” But, while your period might get heavier (or you may spot in between), if you notice that it has gotten lighter or disappeared all together while your IUD is in, that’s a sign that you could be pregnant with an IUD.

Your IUD is shaped like the letter “T,” with thin strings at the bottom that are used to ensure that it can be removed easily if you ever decide you do want to get pregnant. If you can’t feel the strings, that doesn’t mean that your IUD has moved. But, in rare cases where your IUD has undergone expulsion or perforation, you might not be protected against pregnancy, especially if you’ve had sex. If you’re unsure if your IUD is still in place, you can schedule an appointment with your OB-GYN, who can confirm its location.

One sign of pregnancy that absolutely shouldn't be ignored is pain, especially in your abdomen. “If you are having abdominal or pelvic pain that does not go away with over the counter pain medications, or you are having heavy vaginal bleeding, you need to be evaluated immediately,” explains Farid. Unfortunately, pain can be a sign of something more worrisome. “Women who do get pregnant while using an IUD have an increased risk of an ectopic pregnancy, which is very risky for a woman's health.”

Here’s how it happens. During an ectopic pregnancy, the fertilized egg doesn’t grow in the uterus (where it’s supposed to), but rather in the fallopian tube, although it can occur in the ovary, or even the cervix. It can lead to pelvic or abdominal pain, vaginal bleeding, and pregnancy loss. And if you experience sudden severe pain in your abdomen, shoulder, or lower back, or feel cramping on one side of your pelvis, or even faint, you should go to the emergency room, the American College of Obstetricians and Gynecologists reminds us.

Can’t get out of bed lately? Even with an IUD, you might be pregnant, Dr. Langdon explains. “Fatigue is a big sign that you might be expecting,” she says. If you’ve been pregnant before, you might recognize that all-consuming tiredness you feel early on when you’re expecting. So, if all you want to do is sink into your bed and sleep all day, you might want to take a pregnancy test, just in case.

OK, so this one is pretty obvious. When you’re happy with your IUD, it might be hard to even imagine that you could be pregnant. So, if you’re experiencing symptoms, why not take a test to assuage your fears? “If you’re having spotting, bleeding, breast tenderness, or fatigue, you could very well be pregnant, even with an IUD,” says Langdon. If it is positive, call your OB-GYN right away to figure out the next steps to ensure your health and safety.