Short- and long-term effect of contraceptive methods on fecundity

Elina Berglund Scherwitzl; Olof Lundberg; Helena Kopp Kallner; Simon P Rowland; Jan Holte; James Trussell; Kristina Gemzell Danielsson; Raoul Scherwitzl

doi:10.1080/13625187.2019.1621999

Short- and long-term effect of contraceptive methods on fecundity

Berglund Scherwitzl E, Lundberg O, Kopp Kallner H, Rowland SP, Holte J, Trussell J, Gemzell Danielsson K, Scherwitzl R

Published August 2019 The European Journal of Contraception & Reproductive Health Care : the Official Journal of the European Society of Contraception, 24(4), 260-265

DOI 10.1080/13625187.2019.1621999 PMID 31223036 PMC PMC6689758

RRM Academy Synopsis

Past hormonal contraception users conceived later than past app users

Women off hormonal contraception averaged 3.65 cycles to conceive; women who had used the app as contraception averaged 2.25. This cohort study followed women trying for a baby with the Natural Cycles app. After about five cycles, both groups had similar pregnancy chances.

Key Findings

Of 1284 women who had used the app to prevent pregnancy, 738 became pregnant. Of 1590 women who had used hormonal contraception (HC), 918 did.
Average time to pregnancy was 2.25 cycles (95% CI 2.07, 2.43) after app use and 3.65 cycles (95% CI 3.43, 3.87) after HC.
The Kaplan–Meier ratio for time to reach a 30% pregnancy probability was 1.62 (95% CI 1.45, 1.78), with HC as the control group.
In the three younger age categories, previous app users reached 30% pregnancy probability significantly sooner than previous HC users. Cycles without ovulation were 3.5%, with no significant group difference.

Interpretation

Participants were women planning a pregnancy. Most were from Sweden. The authors note that past hormonal contraception use may have hidden conditions that affect fertility in that group. The findings support larger studies on how fertility awareness experience affects time to pregnancy.

RRM Context

Hormonal contraception is a suppressive medication. Women who stopped it conceived later than earlier app users in the early cycles. Ovulation rates were similar between groups. The delay did not come from fewer ovulations. The authors say knowledge of a fertility awareness-based method may help women conceive faster. These methods track the fertile window.

Our editorial summary of this paper, not the article's abstract.

Abstract

Objective

The aim of the study was to compare the effect of previously used contraceptive methods on women's short- and long-term fecundity. Use of hormonal contraception (HC) was compared with the use of a contraceptive mobile application (app).

Methods

This real-life prospective observational study comprised 2874 women who were attempting to become pregnant using the Natural Cycles mobile app to monitor their fertility. The women registered to use the app between August 2014 and June 2016 with the intention of planning a pregnancy and had previously either used the same app to prevent pregnancy or had recently discontinued HC use. We calculated the average time to pregnancy (TTP) for all women who became pregnant during the study and performed Kaplan-Meier life-table analysis to examine the cumulative probabilities of pregnancy for all women in the study.

Results

The average TTP was 2.3 (95% confidence interval [CI] 2.1, 2.4) and 3.7 (95% CI 3.4, 3.9) cycles for women who had previously used Natural Cycles and HC, respectively. The time to reach 30% pregnancy probability for women previously on HC was 1.6 (95% CI 1.5, 1.8) times longer than for women previously using Natural Cycles. There was no significant difference in the 13 cycle cumulated pregnancy probability between the two groups.

Conclusion

The results show that fertility awareness-based methods of contraception increase short-term pregnancy rates relative to HC, but have no effect on long-term pregnancy rates.

Topics

Contraception

Comparative Studies Contraception Versus Fertility Awareness

Contraception › Comparative Studies › Contraception Versus Fertility Awareness

Elina Berglund Scherwitzl, Olof Lundberg, Helena Kopp Kallner, Simon P Rowland, Jan Holte, James Trussell, Kristina Gemzell Danielsson, Raoul Scherwitzl

E Scherwitzl, O Lundberg, H Kallner, S Rowland, J Holte, Jim Trussell, Jimmy Trussell, J Trussell, K Danielsson, R Scherwitzl

PMID 31223036 31223036 DOI 10.1080/13625187.2019.1621999 10.1080/13625187.2019.1621999 Berglund Scherwitzl et al. 2019, Berglund Scherwitzl 2019

Keywords

Contraceptive Agents, Hormonal

Short- and long-term effect of contraceptive methods on fecundity

Past hormonal contraception users conceived later than past app users

Key Findings

Interpretation

RRM Context

Abstract

Topics

By this author

Related research

Keywords