19 Nov Some Women Experience Delay in Fertility After Discontinuing Contraceptives

MedicalResearch.com Interview with:

Jennifer Yland

Jennifer Yland
Doctoral Student in Epidemiology
Harvard T.H. Chan School of Public Health

MedicalResearch.com: What is the background for this study?

Response: Worldwide, about 22% of reproductive-aged women used hormonal contraception last year. Long-acting reversible contraceptive (LARC) methods, which include intrauterine devices (IUDs), implants, patches, and injectable contraceptives, have become increasingly popular. However, little is known about the return to fertility after use of different contraceptives, particularly LARC methods.

MedicalResearch.com: What are the main findings?

Response:We evaluated the relationship between use of a variety of contraceptive methods and subsequent fertility among nearly 18,000 female pregnancy planners in North America and Denmark. Time to pregnancy varied by contraceptive method but did not depend on lifetime duration of use. Women who used injectable contraceptives had the longest delay in return of normal fertility (five to eight cycles), followed by users of patch contraceptives (four cycles), users of oral contraceptives and vaginal rings (three cycles), and users of hormonal and copper intrauterine devices and implant contraceptives (two cycles).

MedicalResearch.com: What should readers take away from your report?

Response: For all hormonal contraceptive methods evaluated, delays in return to fertility were temporary. However, the contraceptive action of certain methods, such as injectables, may temporarily persist after discontinuing contraception.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Response: Future research should evaluate the potential associations between pregravid use of hormonal contraceptives and perinatal outcomes.

MedicalResearch.com: Is there anything else you would like to add? Any disclosures?

Response: This is the largest study to date on this topic, and we were able to prospectively evaluate use of less common contraceptive methods. Understanding the comparative effects of different contraceptives on fecundity is important for family planning and management of infertility.

Competing interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf (available on request from the corresponding author) and declare: support from the National Institute of Child Health and Human Development and Danish Medical Research Council for the submitted work. KJR is an employee of RTI Health Solutions, an independent non-profit research organization that does work for government agencies and pharmaceutical companies. LAW does consultancy for AbbVie. KAB is an employee of Vertex Pharmaceuticals. In the last three years, Pregnancy Study Online has accepted in-kind donations from: Sandstone Diagnostics, Swiss Precision Diagnostics, Kindara.com, and FertilityFriend.com. The Department of Clinical Epidemiology, Aarhus University Hospital, receives funding for other studies from companies in the form of research grants to (and administered by) Aarhus University. None of these studies has any relation to the present study. The authors report no other relationships or activities that could appear to have influenced the submitted work.

Citation:

Yland Jennifer J, Bresnick Kathryn A, HatchElizabeth E, Wesselink Amelia K, Mikkelsen Ellen M, Rothman Kenneth J et al. Pregravid contraceptive use and fecundability: prospective cohort study BMJ  2020;  371 :m3966

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Last Updated on November 19, 2020 by Marie Benz MD FAAD