The effect of depo-medroxyprogesterone acetate on pituitary and ovarian function, and the return of fertility following its discontinuation: A review

Early adolescent Depo-Provera exposure increases stillbirths in adult sooty mangabeys

“…On average, the adult-treated females gave birth as often as did their matched controls during the study period, and the adolescent-treated females actually gave birth more often than did their matched controls. These results are consistent with findings from studies of human MPA users, in which rates of conception have been shown not to differ between former MPA users and age-matched controls (Schwallie & Assenzo 1974). The increased reproductive output of the adolescent-treated females was likely related to their increased incidence of infant mortality.…”

“…When considering only first births, adolescent-treated females still had an increased incidence of stillbirth as compared to their matched controls, indicating that this finding was not related to the fact that some treated females contributed more births toward the total count of births during the study period than did others. Several adolescent-treated females experienced repeated stillbirths, and stillbirths even three pregnancies out from (and more than 3 years after) their final MPA injections, indicating that stillbirth was not the result of lingering MPA (Schwallie & Assenzo 1974, Fotherby et al 1980. Within the treated subjects, we found that females exposed to MPA prior to first ovulation had a significantly higher incidence of stillbirth post-treatment as compared to females placed on MPA treatment at any point after first ovulation (as nulliparous ovulatory adolescents or parous adults).…”

“…Consistent with findings from studies of human MPA users (Pardthaisong et al 1980, Lan et al 1984, Garzes-Flores et al 1985, latency to resumption of ovulation was seemingly unrelated to reproductive experience prior to treatment, weight at last treatment, or total drug exposure. Women show considerable variation in the rate at which they metabolize MPA (Schwallie & Assenzo 1974, Fotherby et al 1980, and individual differences in MPA metabolism and clearance were likely responsible for the observed variation in latency to resumption of ovulation after the final MPA injection. We found no evidence that MPA exposure negatively impacted post-treatment rates of conception for either adult-or adolescent-treated females.…”

Choosing non-oral, long-acting reversible contraception

“…18 Return to fertility can take 12-18 months so a woman's pregnancy plans need to be considered. 19 The initial bleeding pattern can include irregular, prolonged or frequent bleeding but up to 70% of women develop amenorrhoea by 12 months. [20][21][22] When the injection is given within the first five days of the natural cycle it will be effective…”

Risques vrais et faux de la contraception hormonale injectable

“…Une étude américaine [18] à propos de femmes souhaitant une gros sesse après l'arrêt des injections trimestrielles, montre que le délai moyen de conception est de 10 mois après la fin théorique de la protection contracep tive. Ce délai est de 3 mois environ après l'abandon de la pilule ou le retrait de l'appareil intra-utérin.…”