Return to fertility following discontinuation of oral contraceptives

Objectives: To provide an overview of the studies that have evaluated the return to fertility following cessation of oral contraceptives (OCs), including recent evidence in women discontinuing extended-cycle and continuous-use regimens. Design: Comprehensive review. Patient(s): None. Intervention(s): Relevant articles were identified through a PubMed literature search (1960–2007) and a cross-reference of published data. Main Outcome Measure(s): Time to fertility following contraceptive use. Result(s): Numerous studies have demonstrated some delay in the time to conception in previous users of OCs who discontinued use in order to conceive, but this impairment appears to be temporary and typically limited to the early months following cessation of OC use. Reported 12-month conception rates in former cyclic OC users range from 72%–94% and are similar to those observed in women discontinuing intrauterine devices (71%–92%), progestin-only contraceptives (70%–95%), condoms (91%), and natural family planning (92%). There is a limited amount of data on the time to conception in women stopping extended-cycle and continuous-use OCs, but the data suggest that subsequent return to fertility is generally comparable to that of cyclic OCs. Conclusion(s): A comprehensive survey of reported data indicates that the return of fertility in former OC users (both cyclic and extended/continuous regimens) in women who stop use in order to conceive is comparable to that observed with other contraceptive methods. [Copyright &y& Elsevier]