Hormonal Contraceptive Use May Delay Return of Fecundability

WEDNESDAY, Nov. 18, 2020 — Pregravid use of some hormonal contraceptives is associated with delays in return of fertility, according to a study published online Nov. 11 in The BMJ.

Jennifer J. Yland, from the Boston University School of Public Health, and colleagues examined the correlation between pregravid use of a variety of contraceptive methods and subsequent fecundability in a prospective cohort study. Data were included for 17,954 women who had tried to conceive for up to six menstrual cycles at study entry. Contraceptive histories and personal, medical, and lifestyle characteristics were reported at baseline.

The researchers found that about 38, 13, and 31 percent of participants had recently used oral contraceptives, long-acting reversible contraceptive methods, and barrier methods, respectively. Compared with users of barrier methods, women who had recently stopped using oral contraceptives, the contraceptive ring, and some long-acting reversible contraceptive methods experienced short-term delays in return of fertility. There was a correlation seen for use of injectable contraceptives with decreased fecundability compared with barrier method use (fecundability ratio, 0.65). The longest delay in return of normal fertility was seen for users of injectable contraceptives, followed by users of patch contraceptives, users of oral and ring contraceptives, and users of hormonal and copper intrauterine devices and implant contraceptives (five to eight, four, three, and two cycles, respectively).

“Our results, although imprecise, indicate little or no lasting effect of long-term use of these methods on fecundability,” the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.

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