Concerns on future fertility among users and past-users of combined oral contraceptives: a questionnaire survey

Abstract

Objective: The combined oral contraceptive pill is the most preferred contraceptive method worldwide. Despite high life-time prevalence of infertility of 16–26%, scarce data about concerns of future fertility among COC users are available. We aimed to study whether COC usage induces concerns about fertility.

Methods: Online questionnaire-based survey included 1283 current COC users and 1006 past users. The questionnaire covered knowledge and concerns of various aspects of fertility with respect to COC usage.

Results: Significantly, more current users (66%) than past users (52%) had considered whether or not COC usage could affect future fertility (OR = 1.6, 95% CI 1.3–1.9). Nearly 50% of both groups believed COC usage could impair conception rates after discontinuation. Furthermore, 28% current vs. 19% past users believed COC could diminish the ovarian reserve more permanently. Conversely, 14% current and 11% past users believed that lack of ovulation could ‘spare’ the eggs (OR = 0.9, 95% CI 0.7–1.3). Significantly fewer current users (22%) vs. past users (35%) had heard, primarily by female friends, that a short break of 1–2 months during long-term COC usage was healthy, (OR 0.72, 95%CI = 0.56–0.92).

Conclusions: Health care professionals prescribing hormonal contraception should be aware of misapprehensions and concerns of fertility among users of COC.

摘要

目的：复方口服避孕药是世界上最优选的避孕方法。尽管女性一生中不孕症患病率高达16％至26％, 但仍缺乏关于COC使用者对未来生育能力担忧的数据。本文旨在研究使用COC是否会引起人们对生育的担忧。方法：基于在线问卷调查, 包括1283位当前COC使用者和1006位曾用者。该调查表涵盖了关于生育能力与COC使用有关的各个方面的知识和热点。结果：值得一提的是, 考虑使用COC是否会影响未来的生育力的女性（OR = 1.6, 95％CI 1.3-1.9）, 当前使用者（66％）比曾用者（52％）多。两组中近50％的女性认为停用COC后可能会影响受孕率。此外, 有28％的现用者和19％的曾用者认为, COC可以更永久地减少卵巢储备。相反, 有14％的现用者和11％的曾用者认为不排卵会“储备”卵（OR = 0.9, 95％CI 0.7-1.3）。认为长期使用COC短暂停药1至2个月是健康的COC现用者（22％）明显少于曾用者（35％）, 该信息主要来自于女性朋友, （OR =0.72, 95％CI = 0.56-0.92）。结论：开具激素避孕药处方的医疗保健专业人员应意识到使用COC女性对COC的误解和对使用COC影响生育能力的担忧。

Keywords:

• Combined oral contraception
• fertility awareness
• fertility concerns
• misapprehensions
• ovarian reserve

Acknowledgements

The authors thank sociologist Caecilie Rahbek Schou for her valuable work during the preparation of the questionnaire.

Disclosure statement

None of the authors had any conflict of interests.

Additional information

Funding

This study is part of the ReproUnion collaborative study, co-financed by the European Union, Interreg V ÖKS. The authors thank Roche Diagnostics for co-financing. The funders had no role in the study.