Can Contraceptives Cause Infertility?
Can Contraceptives Cause Infertility?
“There’s an awful lot of misinformation out there. Scan the Internet or even ask a random sampling of medical professionals, and you’re bound to get contradictory responses about how contraceptives such as the Pill, the IUD (intrauterine device), and Depo-Provera affect your fertility. To set the record straight, we asked experts for the latest, most up-to-date information. The good news: “With a few notable exceptions, immediately after you stop using birth control, your fertility will go right back to what it was destined to be,” says Paul Blumenthal, M.D.
Notice that Dr. Blumenthal did not say that your fertility will go back to whatever it was before you started using the method, and he doesn’t say that it will go back to being perfect. While in most cases you will go back to being as fertile as you would have been had you not been using birth control, that level of fertility still depends on many things that have nothing to do with your contraceptives.
If you relied on condoms or a diaphragm for birth control, your return to fertility is as simple as leaving them in your night-table drawer. “Barrier methods only work while they are on the body or in the body,” Dr. Blumenthal points out. As a bonus, condoms can actually help your fertility by protecting you against sexually transmitted diseases (STDs) such as chlamydia and gonorrhea, which can lead to infertility.
Talk to five different women about oral contraceptives, and you’ll get five different opinions about what sort of effect they have on fertility. Some women swear their years on the Pill made their cycles regular and ultimately helped them conceive. Others are convinced that all those synthetic hormones must have wreaked havoc with their ovaries. Jane Kikuchi’s story is one doctors hear all the time:
Still other women worry so much about how lingering effects of the Pill might harm their fetus that they use a condom for months before attempting to get pregnant. “Patients have the misconception that when they go off the Pill that it somehow has to wash out of their system before they get pregnant,” “But there have been lots of babies who were conceived when their mothers were on the Pill, and numerous studies have shown there is absolutely no increased risk of birth defects for those babies.”
As for the notion that it takes several months for ovulation to “kick in” after stopping the Pill—it’s simply not true.
The good news about the Pill and pregnancy is that oral contraceptives can actually give you a boost in preserving your fertility by lowering your chances of getting uterine and ovarian cancer. It can also suppress the symptoms of endometriosis, in which the uterine lining grows outside the uterus, causing fertility problems.
Depo-Provera, a contraceptive injected into a woman’s arm or buttocks once every three months to prevent ovulation, is not intended for women who want to be pregnant any time soon. And doctors should always inquire about a woman’s timetable for family planning before prescribing the drug.
That’s because Depo-Provera, while a highly effective method of birth control, is also the one hormonal contraceptive that can have lingering effects on fertility. “Even though Depo-Provera stops working reliably as birth control after three months, it persists in your body for many months longer because it’s deposited in the muscle. Once it’s in there, it takes time for it to work its way out,” Dr. Davis explains. Research has shown that the median time for return to fertility is 10 months after the last shot, though pregnancy can occur as soon as three months after. A year and a half after the last shot, the rate of pregnancy for former Depo users is the same as the general population’s.
Intrauterine devices have been making a big comeback in the last few years after a long period in which they were on everyone’s blacklist. Back in the 1980s, there were a lot of reports charging that certain IUDs caused pelvic inflammatory disease (PID), which could lead to infertility. “What we have now learned is that the issue is not the device itself, but the exposure to STDs, often through multiple sexual partners,” Dr. Blumenthal explains. Analysis of extensive data from the World Health Organization has shown that when IUDs are given to appropriate patients (mainly women in mutually monogamous relationships), the risk of PID is extremely low, with only a slightly increased risk during the first few weeks after insertion.
When the IUD is removed, the return to fertility is rapid. “When you remove the IUD, since the ovary is not really affected in the first place, within a cycle or so the uterus recovers, the effect of the IUD is gone, and fertility returns to whatever level it was destined to be.” According to data from the Association of Reproductive Health Professionals, conception rates following IUD removal are not significantly different from the rest of the population’s.”
Whichever birth control method you’ve relied on, the important thing to remember is that once you go off of it, you must be prepared for pregnancy. “We see so many women who go off birth control and didn’t think they could get pregnant quickly, and then boom, they’re pregnant by dinnertime,” says Dr. Blumenthal. Wouldn’t it be nice if it were always so easy? “
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h/t to parenting.com for the great info!