Fertility after discontinuation of contraception: a comprehensive review of the literature.
BACKGROUND
Fear of adverse effects on subsequent fertility following reversible contraceptive use is an important concern for some women.


METHODS
We undertook a comprehensive and objective review of the literature for prospective studies reporting pregnancy rates in women following contraceptive cessation. One-year pregnancy rates and pregnancy outcomes are summarized.


RESULTS
We identified and analyzed 17 studies according to preset criteria. Typical 1-year pregnancy rates following cessation of oral contraceptives or the levonorgestrel-releasing intrauterine system (LNG-IUS) ranged between about 79% and 96% and those for copper intrauterine devices (IUDs) were almost as high, ranging between about 71% and 91%. One-year pregnancy rates following cessation of contraceptive implants were between 77% and 86%, with one study showing a rate lower than 50%. For injectable contraceptives [(a) norethisterone enanthate and (b) 5 mg estradiol cypionate and 25 mg medroxyprogesterone (Cyclofem)], only two studies were reported, with 1-year pregnancy rates following cessation of 73% and 83%, respectively. There was no evidence of increased pregnancy complications or adverse fetal outcomes following cessation of any of the reversible methods reported.


CONCLUSIONS
Overall, 1-year pregnancy rates following cessation of oral contraceptives, contraceptive implants and monthly injections, copper IUDs and the LNG-IUS are broadly similar to those reported following discontinuation of barrier methods or use of no contraceptive method.
Newcastle Sexual Health Services, New Croft Centre, Newcastle upon Tyne NE1 6ND, UK. diana.mansour@newcastle-pct.nhs.uk
Diana
D
Mansour
Kristina
K
Gemzell-Danielsson
Pirjo
P
Inki
Jeffrey T
JT
Jensen
D003271:Contraceptive Agents, Female; D003277:Contraceptives, Oral, Combined; D005260:Female; D005298:Fertility; D006801:Humans; D007435:Intrauterine Devices, Copper; D007436:Intrauterine Devices, Medicated; D016912:Levonorgestrel; D011247:Pregnancy; D011256:Pregnancy Outcome
D003271:Contraceptive Agents, Female; D003277:Contraceptives, Oral, Combined; D016912:Levonorgestrel