Fertility in older women following removal of long-term intrauterine devices in the wake of a natural disaster

Zhu, Huili; Lei, Haike; Huang, Wei; Fu, Jing; Wang, Qiushi; Shen, Licong; Wang, Qiuyi; Ruan, Jie; Liu, Dong; Song, Hao; Hu, Lina

doi:10.1016/j.contraception.2012.11.002

Cited by 13 publications

(13 citation statements)

References 25 publications

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“…The findings of this study are in contrast to the previous studies that found an association between previous IUD use and infertility,[4, 5, 14] but are consistent with older studies that found no association between IUD use and reduced fertility. [new 7–13, 15] Our findings are also consistent with Hubacher et al who found no association between IUD use and infertility once they controlled for important confounding variables, such as history of Chlamydia trachomatis infection. [13] It is important to note that most of these published studies included IUDs that are different from the ones currently available in the U.S.…”

Section: Discussionsupporting

confidence: 90%

Fertility after Intrauterine Device Removal: A Pilot Study

Stoddard

Madden

et al. 2015

The European Journal of Contraception & Reproductive Health

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Background Despite high efficacy, only 7.7% of women in the United States currently using contraception use an IUD. There is little published contemporary data about fertility rates after IUD use, especially in nulliparous women and women using the hormonal IUD. Study Design We recruited sexually active women 18–35 years of age enrolled in the Contraceptive CHOICE Project who had discontinued a contraceptive method and desired pregnancy. Results In this pilot project, we enrolled 69 former IUD users (50 copper and 19 levonorgestrel) and 42 former non-IUD users. Pregnancy rates at 12-months were similar between the two groups; 81% of IUD users became pregnant compared to 70% of non-IUD users (p=0.18). In the Cox model, there was no difference in the time to pregnancy in IUD users compared to non-IUD users (HRadj 1.19, 95% CI 0.74–1.92). African American race was the only variable associated with reduced fertility (HRadj 0.40, 95% CI 0.24–0.67). Conclusions We found no difference in 12-month pregnancy rates or time to pregnancy between former IUD users and users of other contraceptive methods. However, there was a clinically and statistically significant reduction in fertility in African American women.

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Section: Discussionsupporting

confidence: 90%

Fertility after Intrauterine Device Removal: A Pilot Study

Stoddard

Madden

et al. 2015

The European Journal of Contraception & Reproductive Health

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“…42 Bleeding/pain 995 parous adolescents paired with adult women 10 y older: removals up to 4th year of use was 16.5 and 8.7/100 W-Ys among adolescents and adult women, respectively; 45 Users of the LNG-IUS up to 6 y the rates among women between 16-35 y old was 2.3/100 W-Ys and among women older than 35 y it was 4.0/100 W-Ys; 46 A systematic review with LNG-IUS users up to 25 y old reported an OR (95% CI) of 5.38 (0.25-113.51); 47 Other authors reported an OR of 2.13 (95% CI 0.19-23.89); 48 Adolescents and young women aged 13-24 y followed up to 30 mo the rates were similar (35.6% of LNG-IUS vs 38.6% of Cu-IUD). Pain rates (including dyspareunia) was 27/100 W-Ys and AUB was 20.9/100 W-Ys; 36 PID With the two low-dose LNG-IUS (8 and 13) women 18-25 y old showed similar rate of PID as women 26-35 y old (crude incidence: 0.2% vs 0.6%, respectively); 18 Age and duration of IUD use were independently associated with reduced fertility; 34 Conception rates (women 16-35 y old) 86.1% became pregnant within 12 mo after LNG-IUS removal. 35…”

Section: Pregnancymentioning

confidence: 96%

“…18 Another study that investigated the PID incidence rates in women with HIV infection reported a rate of 1.2/100 W-Ys (95% CI 0.3-4.6) among LNG-IUS users compared with a rate of 0.7/100 W-Ys, (95% CI 0.1-4.9) (p = .68) among Cu-IUD users. 33 A previous study 34 that investigated the return of fertility after Cu-IUD removal in 1770 women reported that 80.1% of the women became pregnant after IUD removal and 88.0% conceived within a year. Women's age and duration of IUD use were independently associated with reduced fertility.…”

Section: Us E Of Copper-b E Aring I Uds and The Lng -I Us Among Adole Scents And N Ulli G R Avida Smentioning

confidence: 99%

“…A previous study 34 that investigated the return of fertility after Cu‐IUD removal in 1770 women reported that 80.1% of the women became pregnant after IUD removal and 88.0% conceived within a year. Women's age and duration of IUD use were independently associated with reduced fertility.…”

Section: Use Of Copper‐bearing Iuds and The Lng‐ius Among Adolescents And Nulligravidasmentioning

confidence: 99%

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Intrauterine device use is safe among nulligravidas and adolescent girls

Bahamondes¹,

Bahamondes

2021

Acta Obstet Gynecol Scand

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The use of intrauterine devices (IUDs), including the copper‐bearing device and the levonorgestrel intrauterine system (LNG‐IUS), is safe among nulligravidas and adolescent girls. However, several misconceptions limit their use in clinical practice; health‐care providers are hesitant to prescribe IUDs, and several myths associated with their usage in nulligravidas and adolescents exist among both providers and women themselves. The high rates of unplanned pregnancies (which in many settings constitute a public health issue, primarily among adolescent females) can be attributed at least partially to lack of awareness and limited use of highly effective contraceptives such as IUDs. In this review, we discuss the role of non‐hormonal and hormonal IUDs as effective contraceptives in nulligravidas and adolescent girls. We present a literature review of data that highlight contraceptive efficacy, side effects (including reasons for discontinuation), and continuation rates with the method. We searched the PubMed/MEDLINE, Cochrane Library, Embase, and Scopus databases for all articles published in English between January 1990 through September 2020. A large body of evidence confirmed the effectiveness of IUD/IUS, independent of age and parity. Studies showed a high expulsion rate among adolescents but not among nulligravidas. Additionally, bleeding patterns among adolescents and nulligravidas were similar to those observed among adults and parous women. The high early removal rates observed in adolescents were attributable to bleeding and/or pain, which indicate that compared with adults, adolescents are less likely to accept IUD‐induced side effects. IUD placement is an excellent strategy to avoid the high rates of unplanned pregnancies in adolescents and nulligravidas. IUDs are more effective than short‐acting reversible contraceptives with failure rates that are equivalent to those observed with permanent contraception. However, few long‐term studies have investigated this category of women to definitively establish the role of IUD/IUS as effective means of contraception.

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“…Long-term usage is not associated with posterior infertility; several studies have shown pregnancy rates are not delayed in women who used copper IUDs for several years [106]. Zhu et al performed a study with 1770 Chinese women who had their IUDs removed after a catastrophic earthquake in the Sichuan region and were followed up for two years [103]. 71% women conceived within 1 year after removal and 80% conceived within 2 years.…”

Section: Return To Fertilitymentioning

confidence: 99%

Contraceptive Methods and the Subsequent Search for a Pregnancy

Balbás¹,

Balbás²,

Rivera³

2018

Family Planning

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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.

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Fertility in older women following removal of long-term intrauterine devices in the wake of a natural disaster

Cited by 13 publications

References 25 publications

Fertility after Intrauterine Device Removal: A Pilot Study

Fertility after Intrauterine Device Removal: A Pilot Study

Intrauterine device use is safe among nulligravidas and adolescent girls

Contraceptive Methods and the Subsequent Search for a Pregnancy

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