Return of fertility after discontinuation of contraception: a systematic review and meta-analysis.
Level 3 - non-randomized controlled study
Systematic review and meta-analysis of observational follow-up studies
PubMed 30062044 · doi:10.1186/s40834-018-0064-y
What was done
A systematic review and meta-analysis evaluated pregnancy resumption rates following contraceptive discontinuation. Five databases (PubMed/Medline, Global Health Database, Embase, Cochrane Library, and African Index Medicus) were searched from 1985 to 2017. Pooled conception rates within 12 months post-discontinuation were calculated using a random-effects model, and heterogeneity and publication bias were assessed.
What was found
Across 22 studies enrolling 14,884 women, the pooled pregnancy rate within the first 12 months after contraceptive discontinuation was 83.1% (95% CI = 78.2–88%). Rates did not differ significantly between hormonal methods and IUD users. Progesterone type and duration of oral contraceptive use did not significantly affect fertility resumption; the effect of parity remained inconclusive.
Why it matters
These findings provide pooled quantitative reassurance for clinical counseling that previous contraceptive use does not meaningfully impair or delay subsequent fertility.
Limits
The abstract does not provide specific heterogeneity statistics (I-squared value), numerical subgroup rates, or details on individual study designs. Potential confounders such as participant age, partner fertility status, and coital frequency are not reported in the abstract.
Cited by
- supports Large population studies show that previous use of contraception does not increase the rate of infertility at 12 months post-discontinuation.
- 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.