Contraceptive Methods and the Subsequent Search for a Pregnancy

Many women are concerned about their future fertility, about pregnancy complications and about the health of their future child when choosing a contraceptive method and sometimes women want to interrupt the contraception – maybe after years of use – in order to attempt pregnancy. Return to fertility, has been thoroughly analyzed in the literature. This chapter provides evidence-based information and discusses the potential doubts of women. Return to fertility has been consistently found to be sure, albeit sometimes slightly slow in the short term: pregnancy rates after 1 year of contraceptive interruption are 79–95% for oral contraceptives, 79–96% for levonorgestrel IUD, 71–91% for copper IUDs, around 80% for implants and 75–80% for injectable contraceptives. About 50% women are pregnant 3–6 months after contraceptive discontinuation; around 90–95% of women had achieved pregnancy 2 years after stopping their contraceptive method. Some studies have found associated risks of fetal malformations when women take oral contraceptive pills after conception (though other studies disputed these results). However the offspring of women who used oral contraceptives before conception does not show an increased risk of fetal death, miscarriage, gestational hypertension, major newborn structural defects or hypospadias. The effect on birth weight seems small and inconclusive.