Time to Conception after IUD removal: Importance of Duration of Use, IUD Type, Pelvic Inflammatory Disease and Age

Andolsek, L; Teeter, Rebecca A.; Kozuh-Novak, M; Wheeler, R. G.; Fortney, Judith A.; Rosenberg, Michael J.

doi:10.2307/1966975

Cited by 2 publications

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“…Intrauterine device use is, however, known to be associated with an increased risk of pelvic in¯ammatory disease 16,28 and this risk (along with that for bleeding, pain, and expulsion) may be greater in nulliparous than in parous women 29±31 . Pelvic in¯ammatory disease, which is often clinically occult, is, of course, well known to be an important cause of infertility.…”

Section: ±11mentioning

confidence: 99%

Return of fertility in nulliparous women after discontinuation of the intrauterine device: comparison with women discontinuing other methods of contraception

Doll

Vessey

Painter

2001

BJOG

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Objective To clarify the effect of the using the intrauterine device on fertility in nulliparous women.Design Prospective cohort study of two groups of nulliparous women, one recruited while using an intrauterine device and the other while using an oral contraceptive. Setting Seventeen family planning clinics in England and Scotland.Sample 1071 nulliparous, married women, aged 18±40 years, 558 of whom contributed information to the main objective of the study.Methods The women were recruited between 1982 and 1985 and followed up annually to 1994. Dates and reasons for any contraceptive method changes (which were most frequently to barrier methods) were recorded, together with the outcome of any pregnancies, at each follow up. Main outcome measures The number of nulliparous women giving birth at term after stopping contraception (oral contraceptive, intrauterine device or barrier method) in order to conceive.Results Women who stopped using a barrier method to achieve a planned pregnancy conceived most quickly: 54% were delivered after one year vs 39% of intrauterine device and 32% of oral contraceptive users (log rank P 0.002). There was no association between fertility and duration of oral contraceptive use: However, short term intrauterine device users (, 42 months) showed a fertility pattern more favourable than seen in those discontinuing oral contraceptives, with increasing duration of intrauterine device use being associated with decreasing fertility (linear trend P 0.005); the fertility of women who had used the intrauterine device for 78 1 months was the most impaired (28% were delivered by 12 months vs 46% of short term users; at 36 months the corresponding ®gures were 79% vs 91%). This association remained after adjusting for potential confounding factors, including maternal age, husband's social class, and history of gynaecological illnesses, factors which themselves had independent associations with fertility. Conclusions Long term intrauterine device use in nulliparous women appears to be associated with an increased risk of fertility impairment.

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Section: ±11mentioning

confidence: 99%

Return of fertility in nulliparous women after discontinuation of the intrauterine device: comparison with women discontinuing other methods of contraception

Doll

Vessey

Painter

2001

BJOG

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“…Return to fertility after IUD removal has been well reported in the literature for decades; however, some controversy remains over how soon fertility returns and if various IUD formulations affect this differently. Most studies show that overall high rates of women desiring, both nulliparous and parous, are able to achieve pregnancy after removal of both the Cu-IUD and the LNG-IUD within a period of 12 months following discontinuation [37][38][39][40][41][42][43] . Of these studies, only two mention the specific indication for LNG-IUD placement being contraception; additionally, inclusion J Assist Reprod Genet (2020) 37:45-52 Fig.…”

Section: Return To Fertilitymentioning

confidence: 99%

Levonorgestrel IUD: is there a long-lasting effect on return to fertility?

Dinehart

Lathi

Aghajanova

2019

J Assist Reprod Genet

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Intrauterine devices (IUDs) are effective and safe long-acting reversible contraceptive methods for preventing unplanned pregnancies. While extensive studies were conducted to evaluate return to fertility after removal of IUDs, majority of them were focused on multiparous women using copper IUDs. Current trends indicate increased use of levonorgestrel (LNG) IUDs in nulliparous women for very long periods of time, with both nulliparity and long duration of LNG-IUD use being potentially associated with trends towards longer time to conception post removal. Understanding the effects that LNG-IUDs may have on endometrial morphology and gene expression has important implications to further understanding their mechanism of action. Studies examining endometrial gene expression show persistent changes in receptivity markers up to 1 year after removal of an inert IUD, and no similar studies have been performed after removal of LNG-IUDs. Given the current gap in the literature and trends in LNG-IUD use in nulliparous young women, studies are needed that specifically look at the interaction of nulliparity, long-term use of LNG-IUD, and return to normal fertility. Herein, we review the available literature on the mechanism of action of IUDs with a specific focus on the effect on endometrial gene expression profile changes associated with IUDs.

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Time to Conception after IUD removal: Importance of Duration of Use, IUD Type, Pelvic Inflammatory Disease and Age

Cited by 2 publications

References 0 publications

Return of fertility in nulliparous women after discontinuation of the intrauterine device: comparison with women discontinuing other methods of contraception

Return of fertility in nulliparous women after discontinuation of the intrauterine device: comparison with women discontinuing other methods of contraception

Levonorgestrel IUD: is there a long-lasting effect on return to fertility?

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