Barnhart · Fertility and sterility 2009 · narrative review · n=?

Return to fertility following discontinuation of oral contraceptives.

Cited 67 times in the scientific literature.

Level 5 - mechanism / opinion, no new human data

Narrative literature review summarizing published studies without formal systematic review methodology or meta-analytic pooling

PubMed 19268187 · doi:10.1016/j.fertnstert.2009.01.003 · record verified 2026-08-26

What was done

The authors conducted a comprehensive narrative literature review using PubMed searches (1960–2007) and cross-referencing to assess time to fertility following discontinuation of oral contraceptives (OCs), including cyclic, extended-cycle, and continuous-use regimens, compared to other contraceptive methods.

What was found

Studies showed a temporary delay in conception during the initial months following OC discontinuation. Reported 12-month conception rates among former cyclic OC users ranged from 72% to 94%, comparable to rates following discontinuation of intrauterine devices (71%–92%), progestin-only contraceptives (70%–95%), condoms (91%), and natural family planning (92%). Limited data for extended-cycle and continuous-use OCs suggested comparable fertility return to cyclic regimens.

Why it matters

This synthesis provides reassurance that oral contraceptive use does not cause long-term impairment of fertility, with 1-year pregnancy rates matching those seen after stopping non-hormonal and barrier methods.

Limits

As a narrative review, formal meta-analytic pooling, risk-of-bias assessment, and total study/participant counts were not reported in the abstract. Data for extended-cycle and continuous regimens were noted to be limited, and key confounders such as age, duration of contraceptive use, and baseline fertility were not detailed.

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