Return to fertility after removal of a levonorgestrel-releasing intrauterine device and Nova-T.
Level 2 - randomized trial
Prospective follow-up of a subgroup from an individual randomized controlled trial
PubMed 1493717 · doi:10.1016/0010-7824(92)90122-a
What was done
In a European randomized multicenter trial comparing a levonorgestrel-releasing intrauterine device (LNG-IUD, 20 mcg/24 h) to the Nova-T copper device, return to fertility was assessed in 209 women (71 Nova-T, 138 LNG-IUD) who had their device removed to plan a pregnancy. Participants were followed for at least 24 months or until pregnancy termination.
What was found
Cumulative gross conception rates per 100 women were 71.2 at 12 months (79.7 at 24 months) for Nova-T and 79.1 at 12 months (86.6 at 24 months) for LNG-IUD, with no statistically significant difference between groups. In both groups, 96% of pregnancies occurred within the first year after removal. Live births resulted from 84% of pregnancies in the Nova-T group and 86% in the LNG-IUD group.
Why it matters
These findings show that the endometrial suppression caused by LNG-IUD use reverses promptly after removal, with post-removal fertility and pregnancy outcomes comparable to a non-hormonal copper IUD.
Limits
The sample is limited to the subset of women removing devices specifically for planned pregnancy (n = 209). The abstract does not provide exact p-values, confidence intervals, participant age breakdowns, or baseline fertility history.
Cited by
- contradicts After removal of a progesterone IUD, endometrial receptivity is altered for at least six months, leading to lower conception rates during the first six months.