title: Fertility in older women following removal of long-term intrauterine devices in the wake of a natural disaster.
abstract: BACKGROUND
  In order to evaluate the effect of long-term intrauterine device (IUD) use on female fertility, we interviewed 2301 women who lost children in the 2008 Wenchuan earthquake in China, which prompted IUD removal.
  
  
  METHODS
  A clinical retrospective survey.
  
  
  RESULTS
  Five hundred and twenty-four women were lost to follow-up, and data from the remaining 1770 women were analyzed. The completed questionnaires revealed that 80.11% (1418/1770) became pregnant following IUD removal and about 88% (1256) of whom conceived within 1 year. Among women with different durations of IUD use, pregnancy rates and miscarriage rates were as follows: <5 years, 89.77% and 4.27%; 6-10 years, 81.10% and 10.19%; and >10 years, 75.20% and 12.98%, respectively. Age, duration of IUD use, a history of a previous miscarriage and abnormal menstruation before the earthquake were independently associated with reduced fertility, but a higher gravidity pre-earthquake was associated with a higher conception rate.
  
  
  CONCLUSIONS
  Long-term IUD use in older women had a high rate of pregnancy after removal of IUD, but with an increased risk of fertility problems.
authors.affiliation: Department of Obstetrics and Gynecology, West China Second University Hospital of Sichuan University, No. 20, Section 3, Renmin Nan Lu, Chengdu, Sichuan 610041, China.
authors.forename: Huili
authors.initials: H
authors.lastname: Zhu
authors.forename: Haike
authors.initials: H
authors.lastname: Lei
authors.forename: Wei
authors.initials: W
authors.lastname: Huang
authors.forename: Jing
authors.initials: J
authors.lastname: Fu
authors.forename: Qiushi
authors.initials: Q
authors.lastname: Wang
authors.forename: Licong
authors.initials: L
authors.lastname: Shen
authors.forename: Qiuyi
authors.initials: Q
authors.lastname: Wang
authors.forename: Jie
authors.initials: J
authors.lastname: Ruan
authors.forename: Dong
authors.initials: D
authors.lastname: Liu
authors.forename: Hao
authors.initials: H
authors.lastname: Song
authors.forename: Lina
authors.initials: L
authors.lastname: Hu
mesh_terms: D000022:Abortion, Spontaneous / Q000453:epidemiology; D000328:Adult; D000367:Age Factors; D000375:Aging / Q000502:physiology; D002681:China / Q000453:epidemiology; D004190:Disasters; D055866:Earthquakes; D005260:Female; D005298:Fertility; D006801:Humans; D007434:Intrauterine Devices / Q000009:adverse effects*; D008875:Middle Aged; D011247:Pregnancy; D018873:Pregnancy Rate; D012189:Retrospective Studies; D013997:Time Factors; D055815:Young Adult