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Do family planning methods delay conception?

Dear doctor,
I stopped using family planning pills more than a year ago in order to conceive again. Am yet to conceive and I wonder whether it is because of the family planning pills?

Reliable family planning methods (contraception), come in various forms. There are hormone pills, injectables, implants, and devices that get inserted into the uterus or vagina. All these tend to be reversible methods, the potential to conceive should return as soon as their use is stopped. There are also permanent contraceptive methods, which should only be used by those who never ever want to conceive again.

Once you stop using a reversible contraceptive, you should expect to conceive fairly quickly. Some methods, like the injectables, may delay the resumption of regular periods depending on the duration of use. But once the periods resume, implying regular release of eggs (ovulation), conception should then follow. If however you do not conceive within a year, there is usually a likelihood that something else may be affecting your chances of conception.

The best approach is to get a preliminary evaluation and exclude known causes for the delayed conception, which may not be immediately apparent. Your regular gynecologist will suffice as the first point of call. A simple clinical evaluation may immediately pinpoint the problem, and guide appropriate remedial measures. But it’s more likely that you and your partner may need to do some fertility tests.

Initial tests will include sperm analysis, a confirmatory test for ovulation, and a check for the function of your fallopian tubes. Additional tests may also become necessary. Any positive tests will guide on remedial interventions. You may end up with just reassurance that all is well, and simple advise and expectation of conception in the next short while. Unfortunately, some will be diagnosed with an unexpected complex problem affecting their fertility. This would inevitably require more complex fertility treatments.

Anyone on a contraceptive should always remain vigilant about maintaining optimal future fertility. Most contraceptives don’t protect you against sexual infections (STIs), which are linked with infertility. You should always use condoms to guard yourself against STIs depending on your sexual habits, regardless of whatever other contraception you are on. You must also live a healthy lifestyle, avoid toxins, and keep a healthy weight. Any reproductive-related symptoms should be checked promptly.

The vast majority of young and healthy couples who experience a delay in conception after stopping reversible contraception have nothing to worry about. You can be confident that your fertility potential was never compromised by the contraceptive that you were using.

Dr Alfred Murage is a Consultant Gynecologist and Fertility Specialist.

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