Contraception and Fertility :

The intrauterine device



IUD is a contraceptive method , always regarded as very effective, with the advantage of a long duration of action and for which no risk cancer or cardiovascular disease is established.
The risk of a pelvic inflammatory disease (PID) is related to its installation but its occurrence is mainly limited to 3 weeks after insertion.
No tubal infertility has been demonstrated, including nulliparous, but ,theoretically, the risk of infection which can lead to infertility by tubal obstruction exists.
Extra uterine pregnancy, an other potential risk, has not been demonstrated.

The recovery time of fertility and conception following the withdrawal of the IUD are higher than for the sole use of barrier methods (see below), but appears similar to those observed for oral contraceptives, including nulliparous.

Barrier methods

Condoms have longly been used successfully as contraceptive and it shall be recalled that they are the only devices that have been proved efficient in preventing sexually transmitted diseases.

Diaphragms should also be used, in combination with a foam spermicide, but even if used perfectly, their failure rate as protection from pregnancy, is considered 4-8%. They also do not offer a secure protection against sexually transmited diseases.

Oral contraception


"Pills". Two types are used:
1 - Oestro-progestative associations: Combination of estradiol and progesterone derivatives
2 - pure progestative: Progesterone derivatives

These molecules each have advantages and disadvantages (many contraindications) which will encourage your physician to ask a number of questions before choosing the best prescription.

Although it seems that the period of conception is a little longer after stopping oral contraception, it does not exceed 6 months for 65% of couples who have no pathology associated with infertility and who have a normal sexual activity.
Under the same conditions, 90% of fertile couples will have the chance to conceive within 12 months after stopping oral contraception.
A former English study (Farrow. A. et al, 2002) has even suggested that the pill taken over a significant period (5 years) could improve the fertility after stopping the treatment
Several effects have been invoked in order to explain these observations, as the preservation of the oocytes capital (number) or a period of rest in case of possible latent endometriosis.

It should also be pointed out that women , after a prolonged contraception, would like to conceive around 40 years, which actually may cause some difficulties as, for instance, lower percentages of pregnancies arriving to term. That is also the case for pregnancies after in vitro fertilization.
Finally, you do remember that, as for intra-uterine devices, oral contraceptives do not protect against sexually transmitted diseases (STD). You should be aware that some of them could lead to infertility and to treat quickly, in case of occurence, is absolutely necessary.