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Curr Opin Obstet
Gynecol. 2008 Jun;20(3):275-280.
The impact of intrauterine devices on subsequent
fertility.
Skjeldestad FE.
SINTEF Health Research and Institute of
Laboratory Medicine, Childrenʼs and Womenʼs
Health, Norwegian University of Technology and
Science, Trondheim, Norway.
PURPOSE OF REVIEW: To investigate the impact of
intrauterine devices on subsequent fertility.
RECENT FINDINGS: Intrauterine devices are safe,
well tolerated and used by millions of women
worldwide.Subsequent fertility is studied among
women who remove the intrauterine contraceptive
device for planning pregnancy or among women who
have removed the intrauterine contraceptive
device because of intrauterine contraceptive
device-related complications and later on have
become pregnant. Study participants are
recruited from randomized clinical trials on
intrauterine contraceptive device performance or
in case series among women who remove the
intrauterine contraceptive device. Pregnancy
rates after removal are high and are similar to
time-to-pregnancy rates in the general
population. The birth rates are high with a
normal distribution of preterm deliveries,
normal birth weight and sex ratio of newborns.
The ratio of extra-intrauterine pregnancies and
the need for infertility work up are low, and
the distribution of infertility causes among
fully investigated couples is as seen in the
general population. SUMMARY: Despite small
sample size of studies investigating impact of
intrauterine contraceptive devices on subsequent
fertility, the results are consistent and
reassuring on high pregnancy rates, and a normal
distribution of pregnancy outcomes. There are
limited data on return of fertility after usage
of medicated intrauterine contraceptive devices-
more studies are warranted among women who have
used hormone-releasing intrauterine
contraceptive devices.
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