Does contraception affect future fertility?
Dr. John Kennedy, Medical Director, Sims IVF
One of the most common questions that I get asked by couples, when they come to see me first, is whether contraception has an adverse impact on fertility. I know that couples feel particularly vulnerable at this stage in the process, and that confronting an infertility problem is a difficult challenge. The natural reaction is to question everything - including the previous use of contraceptives.
If you’ve been taking ‘The Pill’
The most commonly used method of contraception in Ireland is the oral contraceptive pill. A Danish study in 2013 involving 3,727 women showed that there was no evidence that long-term oral contraceptive pill use had any harmful effects on pregnancy rates(1).
Both short-and long-term pill users were likely to experience a temporary delay in conception, but this does not affect a woman’s chances of getting pregnant. This study has brought good news for users of the pill contraceptive, with respect to future fertility.
If you’ve been using other contraceptives
None of the other reversible contraceptive forms used in Ireland have any permanent effects on fertility either. With the Intra Uterine Devices (IUD’s), Implanon and Depo-Provera, long-term fertility is maintained. Most contraceptives are associated with a temporary reduction in fertility. However with the injection of Depo-Provera it takes an average of 9-10 months before ovulation returns and therefore it may take longer before you can get pregnant. If you want to become pregnant in the next 12 to 18 months I advise you to use a different method of contraception.
The impact of STI’s on fertility
It is important to realise that even though contraceptive use does not permanently affect fertility, certain sexually transmitted infections (STIs) can. None of the previously mentioned contraceptive options protect you from STIs.
One of the most common STI’s in Ireland is chlamydia. This infection can affect both women and men and if left untreated in women it can cause permanent scarring to their fallopian tubes, which can cause problems with fertility. About 70% of women and 50% of men with chlamydia do not have any symptoms and do not know that they have this condition. It is worth having frequent STI checks and use barrier contraceptives.
The impact of ‘bad habits’
There are definite lifestyle and dietary changes that can boost fertility and you can optimise your own chances by changing ‘bad habits’. For instance, we know that stopping smoking can improve your fertility and this is also beneficial for your baby during pregnancy and throughout your child’s life. Being overweight, or underweight, can also affect fertility so aim for a healthy weight to improve your chances of conception. A healthy diet and regular exercise can help you with this. It is important for some people to reduce their caffeine or alcohol intake. You should discuss this with your GP.
A woman’s age
While there may be a number of contributing factors to pregnancy delay, by far the biggest challenge women face is their age. As a woman ages her fertility declines - so we do have a limited timeframe in which to have our own biological children. This decline increases significantly once a woman reaches her mid-30’s.
If you are trying to get pregnant, it is important to understand the factors that can affect your fertility, as well as those that cannot. But if you are starting to feel stressed or confused about the situation, I would recommend you speak to a fertility specialist, particularly if you are over 35. He or she can give personal advice to boost your chances of conceiving, and recommend some fertility tests if necessary too.
(1) Hum Reprod 2013 May;28(5):1398-405. doi: 10.1093/humrep/det023. Epub 2013 Feb 20