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Did contraceptives interfere with my fertility?

Health By Dr Alfred Murage

Dear Doctor,

I am 38 years old with two children. I was on the injectable contraception (Depo provera) for two years, which I stopped in order to conceive again. It’s now three years and I haven’t conceived, and all our fertility tests are normal. Did the contraceptive interfere with my fertility?

Response

Many couples worry that the use of reversible family planning methods may somehow affect chances of future conception.

Such concerns are erroneous. Reversible contraceptives only interfere with conception when in active use.

Once use of a reversible contraceptive has been discontinued, fertility resumes promptly.

Depo provera is a common highly effective and reversible contraceptive. It mainly works by interfering with ovulation (regular release of eggs from the ovaries).

Some women using Depo provera may notice prolonged absences of monthly periods. Once discontinued, resumption of ovulation is indicated by regular periods, with consequent return to fertility. Most women should then conceive quickly.

If, however, a year or more elapses without conception, a gynecological assessment is usually required.

Initial fertility evaluation includes sperm analysis, a confirmatory test for ovulation, and a check for the function of fallopian tubes.

If any tests come out positive, then what gets recommended will depend on the specific results.

Unexplained infertility

Some couples, as is the case with the query above, will not be diagnosed with any specific problems. Such situations are categorised as unexplained infertility, even though additional untested complex factors may be at play.

At the age of 38 and following three years of failure to conceive, referral to a fertility specialist is the best strategy. You should take along copies of all your preliminary fertility tests results.

The fertility expert should review all the results and recommend if additional evaluations will be necessary. You should then be advised on the most appropriate treatment options to help with conception.

Beyond the mid-thirties, egg numbers and quality decline significantly. Sperm quality also declines with advancing age. These factors may explain why you haven’t yet conceived.

Most infertile women at the age of 38 and above, will unfortunately not conceive with simple treatments. You are likely going to end up with a recommendation that you consider having complex fertility treatment.

In-vitro fertilization (IVF), commonly referred to as test-tube babies, may be your best chance of achieving a pregnancy.

If there is ever a delay in conception beyond one year for women below the age of 35, and over six months for those over 35, a fertility evaluation should always be done. It doesn’t matter whether contraceptives were ever used, or not.

  • Dr Alfred Murage is a Consultant Gynecologist and Fertility Specialist; [email protected]

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