Method of contraception used may determine how long it takes until normal fertility resumes
There are many types of contraception available across the globe and their proper use enables and empowers one to make the best sexual and reproductive health choices. The main purpose of contraception is to prevent pregnancy
There are many types of contraception available across the globe and their proper use enables and empowers one to make the best sexual and reproductive health choices.
The main purpose of contraception is to prevent pregnancy. According to data provided by the United Nations Department of Economic and Social Affairs (UNDESA), about 22 percent of women of reproductive age used hormonal contraceptives (namely, contraceptive pills, contraceptive patches and vaginal rings), making them some of the most popular methods of contraception amongst women. It is worth noting here that more that one method of contraception can be used at a time.
Studies show that other methods of contraception are also becoming quite popular in different parts of the world.
The Indian Ministry of Health and Family Welfare (MoHFW), for example, reported that injectable contraceptives are gaining popularity among women in India, especially in states like Rajasthan.
A 2020 report by the US Centers for Disease Control and Prevention (CDC) suggests that though the use of male condoms and oral contraceptives are most common, long-acting reversible contraceptive methods like intrauterine devices (IUDs), injectable contraceptives and implants are becoming more popular than ever before.
Contraception and fecundability
A key focus of research related to contraceptives involves fecundability or a woman’s probability of getting pregnant during a given period of time. Most contraceptives block or control fecundability, so understanding fertility and knowing when you are and aren’t likely to get pregnant is vital for women of reproductive age.
A study published in 2018 in the journal Contraception and Reproductive Medicine says that the return of fertility after discontinuation of contraceptives is a big concern for women and fears about negative consequences on fertility often lead them to not utilize contraceptives at all.
Therefore, fixing a time frame on the resumption of fecundability associated with different types of contraceptives is very important. However, most studies tend to focus on the return of fertility in women who use hormonal contraception, specifically those who use contraceptive pills. Data regarding other methods of contraception and the return of fertility is sparse.
Contraceptive methods and resumption of fertility
A new study published in The BMJ sheds much-needed light on the discontinuation of different contraceptive methods and the resumption of fertility. The study pooled data on women planning pregnancies from the Danish study called Snart Gravid (which includes women aged 18-49 years from 2007 to 2011) and the North American study called Pregnancy Study Online (PRESTO, which includes women aged 21-45 years and their male partners between 2013 and 2019).
A total of 17,954 participants were selected for the final analyses. All selected participants were not pregnant at the beginning of the study, had stopped using contraceptives, were not receiving fertility treatment and were actively trying to conceive. All participants were followed for a period of 12 months, and their resumption of fertility was ascertained by recording when they got pregnant.
Approximately 38 percent of the participants had recently discontinued the use of oral contraceptives, 13 percent had used long-acting reversible contraceptive methods and 31% had used barrier methods like male condoms or diaphragms.
Making the right contraceptive choice
The researchers found that women who had recently stopped using oral contraceptives or vaginal rings and some long-acting reversible contraceptive methods like hormonal or copper IUDs experienced only short-term delays in the return of fertility as compared to those who used barrier methods.
Those who used hormonal or copper IUDs got their fecundability back within two menstrual cycles, while those who used oral contraceptives and vaginal rings did so in three cycles. Women who used patch contraceptives had their fertility returning in four menstrual cycles.
The use of injectable contraceptives was associated with the longest delay in the return of fertility. These users required five to eight menstrual cycles before their fecundability returned to normal levels and they were able to conceive. In case you were unaware, a menstrual cycle roughly represents the time period of a month (28 days in most cases and 21-40 days in other ones).
This means the return of fertility for injectable contraceptive users could easily be around five to eight months, which is much higher than those in other contraceptive methods.
The study also concluded that the long-term use of any method of contraception did not have a lasting impact on fecundability. Your fertility is likely to return to normal even if it does take some time.
While this study had some limitations, the biggest one being that it depended on self-reported data provided by all the participants, it indicates that the return of normal fertility after discontinuing a contraceptive method depends largely on the method itself rather than individual sexual or reproductive health factors.
If nothing else, this study can help women and their doctors make the best decision regarding which contraceptive method to use and for how long.
For more information, read our article on Birth control methods.
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