Fertility after stopping different methods of contraception.

BMJ 1978; 1 doi: 10.1136/bmj.1.6108.265 (Published 4 February 1978) Cite this as: BMJ 1978;1:265

Contraception Drugs: obstetrics and gynaecology Obstetrics and gynaecology Reproductive medicine

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1. M P Vessey, 2. N H Wright, 3. K McPherson, 4. P Wiggins

Abstract
Data on the return of fertility after discontinuing various methods of contraception were collected from among the women taking part in the Oxford-Family Planning Association contraceptive study. Return of fertility was measured as the time taken to give birth to a child. The fertility of both nulligravid and parous women who stopped taking oral contraceptives was initially impaired in comparison with that of women who stopped using other methods of contraception. But the effect of oral contraceptives on fertility had become negligible by 42 months after cessation of contraception in nulligravidae and by 30 months in multiparae. Impairment seemed to be independent of the length of use of oral contraceptives. Data relating to IUD users were sparse, but the figures that were available were reassuring. These results suggest that, although women may have temporary impairment of fertility after discontinuing oral contraception, they are unlikely to become permanently sterile through taking the pill.

Am J Epidemiol. 1997 Aug 1;146(3):258-65.

Oral contraceptives and ovulatory causes of delayed fertility.

Chasan-Taber L, Willett WC, Stampfer MJ, Spiegelman D, Rosner BA, Hunter DJ, Colditz GA, Manson JE. Source
Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.

Abstract
The return of fertility for women who discontinue oral contraceptives takes longer as compared with women who discontinue other methods of contraception. It remains unclear, however, whether subsequent fertility differs according to duration or age at first use. The authors performed a nested case-control study within a cohort of 116,686 female registered nurses residing in 14 US states. Baseline information was reported on mailed questionnaires in 1989. Cases comprised 1,917 married nurses without previous pregnancy who were unable to become pregnant for at least 1 year and were subsequently diagnosed with primary ovulatory infertility. Controls comprised 44,521 married parous nurses with no history of infertility and no pregnancies lasting less than 6 months. After allowing for 2 years of suppressed fertility following discontinuation of oral contraceptive use and excluding women with signs of menstrual or hormonal disorder, the authors found that the multivariate relative risk for ovulatory causes of delayed fertility was 1.2 (95% confidence interval 0.7-1.9) for ever users. There was no statistically significant trend of increasing risk with increasing duration of use and younger age at first use. The fact that 88 percent of cases reported an eventual pregnancy by 1993 suggests that absolute fertility was not impaired.