Can your contraception influence your fertility? We investigate.

So, you have decided it’s time for a baby and have quit your contraceptive method. Now what?

It’s a common question. Can my contraceptive choice harm my chances of falling pregnant? The good news is that it won’t. A number of studies have been conducted on this topic, which have conclusively found that you are just as likely to fall pregnant if you used birth control in the past as a woman who has never used hormonal contraceptives at all. One of the largest studies looked at women who had been using birth control for seven years. The study found that 21% of women fell pregnant within their first fertile month. Of those who didn’t conceive right away, 79.4% were pregnant within the first year, which, say the experts, is similar to the general population’s odds for pregnancy. However, there can be some time delay between when you stop your birth control, and when your fertility returns.

However, what may impact fertility is delaying starting a family, rather than the type of contraception used or the time period it has been used for. Age is one of the most important factors affecting your chance of falling pregnant. Your fertility levels start to decline in your early 30s, with a 40-year-old woman having a 5% chance of falling pregnant naturally in any given month.

ALSO SEE: How to get pregnant faster

Your contraceptive choices and what they mean for fertility

Dr Johannes van Waart, an obstetrician, gynaecologist, fertility expert and founder of Wijnland Fertility, Cape Town says that birth control does not affect your fertility as your ovaries are preprogrammed to produce specific egg cohorts each month. “As an example, we can’t stimulate August’s eggs in May, we can only stimulate May’s eggs in May.”

Therefore, your contraception will not deplete your egg reserves. “The contraceptive pill takes around 48 hours to work out of your system, and thus immediate fertility can return, independent of the length of use.

Dr Nicholas Clark, fertility expert and director of Medfem Fertility clinic in Johannesburg, adds that with the Combined Oral Contraceptive Pill (COCP), hormone levels should return to normal within a few weeks and generally, there is no delay to return to fertility within your next cycle. He adds that since some women on COCP may have had undiagnosed conditions that could affect fertility, such as endometriosis, they may have an increased chance of falling pregnant once off the pill.

Van Waart explains that the Merina or intrauterine contraceptive device (IUCD), will take a month or two before conception is possible, although it may sometimes be sooner. Clark adds that the general rule is that once your menstruation returns, you are considered to have returned to fertility.

Intramuscular contraceptive injections can take up to 10 months before returning to fertility, say both Van Waart and Clarke, and this is usually dependent on the length of use.

However, says Clarke, when it comes to the progesterone implants, once the implant is removed, return to fertility is within a week, “so there should be no delay return to fertility”.

ALSO SEE: 8 things you should know about The Copper Pearls – a new contraceptive

Did you know?

A study, Contraception coverage and methods used among women in South Africa: A national household survey, published in the April 2017 edition of the South African Medical Journal (SAMJ), assessed contraception coverage among 6 296 women aged 15 to 49. The study found that 49,1% used contraception methods of some sort. Most of those surveyed knew about oral contraception (89.9%), which was the most popular method of contraception. While 92% knew about the injectable contraception, however only half had even used this form of contraception. Only 56% knew of IUCD.

The Fertility Show Africa takes place on Friday, March 6, and Saturday, March 7, 2020 at the Gallagher Convention Centre in Midrand, Gauteng. Show times are Friday from 9am to 6pm and Saturday from 9am to 5pm. Learn more at www.fertilityshowafrica.co.za.

The Fertility Show South Africa

More about the experts:

Dr Johannes Van Waart is an an obstetrician, gynaecologist, fertility expert and founder of Wijnland Fertility in Cape Town. Throughout his career he has been involved in research and has authored and co-authored 19 internationally published research papers. Read more about Dr Johannes Van Waart here.

Dr Nicholas Clark, a gynaecologist for over 15 years, joined Medfem Fertility Clinic in 2012 as a director. Nicholas qualified from University College and Middlesex School of Medicine in London in 1990. After completing his training in the United Kingdom and South Africa he was appointed as a consultant gynaecologist at Chris Hani Baragwanath Hospital, Soweto. He is originally from the UK and settled in South Africa in 1997 having worked between the two countries since 1993. Read more about Dr Nicholas Clark here.

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