There are pervasive perceptions in some communities that modern contraceptives will hinder or prevent future fertility. These concerns are documented across diverse global contexts, from sub-Saharan Africa to South Asia, and are sometimes amplified through social networks and influencers who describe perceived dangers of contraceptives — claims not always grounded in science. In the United States, some of these concerns have been weaponized by anti-contraception movements and conservative policymakers who are looking to restrict access to the full range of contraceptive methods.
Concerns linking contraception to infertility have historically been dismissed as “myths” by providers and experts in the broader sexual and reproductive health field who refer to multiple studies documenting that hormonal contraception has no adverse impact on long-term fertility. However, data on short-term delays in return to fertility following contraceptive cessation are less commonly discussed. This lack of nuance and/or dismissiveness around expected short-term delays in return to fertility may be giving way to the recent anti-science movement and amplifying mistrust in health systems, leaving patients to seek information from unqualified online sources rather than evidence-based resources.
In a recent commentary, “Impacts of Contraception on Future Fertility: Addressing Concerns to Improve Understanding,” we help readers cut through the clutter of misinformation and highlight two facts clearly supported by the science: (1) Use of hormonal contraceptives does not cause long-term infertility, and (2) There can be short-term delays (12 months or less) in returning to full fertility after using hormonal contraception, especially for some methods like injectables.
In the commentary, we argue that counseling women that return to fertility will occur “several months after discontinuation,” may be insufficient to set appropriate expectations, particularly for contraceptive injectables, and offer suggestions to improve contraceptive counseling. This includes explicitly acknowledging the reality of short-term delays in return to fertility and providing evidence-based information on the range of time to pregnancy following contraceptive cessation.
Finally, we shed light on the concept of “triple protection.” Coined by Martha Brady, “triple protection,” recognizes the ability of condoms and/or future multipurpose prevention contraceptives to protect against unintended pregnancy and sexually transmitted infections, and, therefore, help protect future fertility, rather than hinder it.
We have a unique opportunity to lay the groundwork now prior to the rollout of future multipurpose prevention technologies to ensure women have accurate information — delivered effectively —about their contraceptive care and return to fertility. If we can effectively communicate the potential for contraceptives (including multipurpose contraceptives) to safeguard fertility, we may help overcome misperceptions and help shift the narrative around contraception to be more grounded in evidence.
About the Authors
Lorna Begg, Population Council
Onikepe Owolabi, Guttmacher Institute
Chelsea B. Polis, Guttmacher Institute