Pregravid contraceptive use and fecundability: prospective cohort study

Area of Science:

• Reproductive Health
• Contraception Research
• Human Fertility Studies

Background:

• Understanding the impact of contraceptive choices on subsequent fertility is crucial for family planning.
• Previous studies have yielded mixed results regarding the duration of fertility return after contraceptive discontinuation.

Purpose of the Study:

• To investigate the association between various methods of contraception used before pregnancy and a woman's subsequent ability to conceive (fecundability).

Main Methods:

• A prospective cohort study involving 17,954 women in Denmark and North America (2007-2019).
• Participants reported contraceptive history and other characteristics at study entry.
• Pregnancy status was monitored via questionnaires for up to 12 months.

Main Results:

• Women discontinuing oral contraceptives, the contraceptive ring, and some long-acting reversible contraceptives (LARCs) experienced short-term fertility delays compared to barrier method users.
• Injectable contraceptive use was linked to reduced fecundability (fecundability ratio 0.65).
• Injectable users had the longest delay in fertility return (5-8 cycles), followed by patch (4 cycles), oral/ring (3 cycles), and IUD/implant (2 cycles) users.

Conclusions:

• Some hormonal contraceptives, especially injectables, are associated with temporary delays in fertility return.
• Long-term use of hormonal contraceptives did not appear to have a lasting negative effect on fecundability.