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Primary infertility and oral contraceptive steroid use
M A Bagwell1, S J Thompson, C L Addy
1Richland Memorial Hospital, Columbia, South Carolina, USA.
Objective:
To determine the association between combined monophasic oral contraceptive (OC) use and primary infertility.
Design:
Case-control.
Setting:
Women serving as controls of the Cancer and Steroid Hormone Study.
Participants:
Women were 19 to 40 years of age at first conception or infertility diagnosis. Based on 24 consecutive months of unprotected intercourse without a recognized conception, 419 nulligravid women had primary infertility; controls were 2,120 fertile women. A calendar of each women's reproductive history was used to determine fertility status and contraceptive use before infertility diagnosis or first conception.
Main Outcome Measure:
Primary infertility.
Results:
Combined monophasic OC use was associated with a lower frequency of primary infertility, particularly among younger (age 20 years) compared with older women (age 30 years) after adjusting for barrier method use and education. A similar association was found for duration of OC use. When adjusted for age at first conception or infertility and barrier method, both higher (> 50 micrograms) and lower (< or = 50 micrograms) estrogen dose use were associated with decreased risk of primary infertility.
Conclusion:
Combined monophasic OC use was associated with a lower frequency of primary infertility.