Bonita

Dear Bonita,

There are several birth control methods, like use of condoms, intra uterine device, hormonal pills and injection. Along with their advantage, they have some side effects as well.  But they do not cause infertility as such. Studies have revealed that a woman using a method of birth control has as much chance of conceiving as one not using it.

Regarding condom use, whether male or female, chances of conceiving are more with its failure, rather than sterility.

Hormonal contraceptives, if used for long, can delay fertility. This happens because overtime, they change the body’s hormonal equilibrium such that the balance needed to become pregnant may no longer be there. The regular menstrual and ovulatory cycle is disturbed. But this is a transient phase. After stopping the hormonal contraceptive, over weeks to six months, the hormonal balance is restored to normal. This enables pregnancy to occur, if the woman decides so. Thus, fertility can be delayed but is certainly not impaired. If a woman fails to conceive after stopping a hormonal contraceptive, other underlying causes for infertility should be looked for as well.

Intra uterine device is yet another mode of family planning. It is useful in spacing between two pregnancies, i.e. to wait to conceive again after a child is born. If aseptic precautions are not observed during insertion of copper intrauterine device T (IUD), it can cause pelvic infection, leading to secondary sterility. However, in proper documented health facilities, due aseptic precautions are always observed, while inserting an IUD. Insertion is done in the period after a menstrual cycle, when chances of pregnancy do not exist, i.e. after excluding pregnancy. A woman desiring to be pregnant can get the device removed. She may conceive just within a week or two of removal of the device.  It may take six months to rarely 12 months for her fertility to recover. Thus, fertility is intact though delayed.

Therefore, it is unlikely for someone to have secondary sterility just due to contraceptive use. If a lady does not become pregnant six months or even longer after stopping contraception, other causes for infertility need to be searched. Sexually transmitted diseases, even if occurred during early teens, can cause pelvic infection and blockade of the fallopian tubes, thus causing secondary sterility. Infection during child birth, can also lead to secondary sterility.

Hormonal disorders like hypo or hyperthyroidism may be detected while testing for secondary sterility.   Other hormonal disorders as that of pituitary gland, adrenal glands, impair fertility, infections of the uterus like endometritis, T.B., may prevent implantation of the fertilised ovum in the uterus.

It is important to remember that if a woman is not becoming pregnant, fault may lie with the male partner as well.

 Dr. Rachna   Pande is a specialist in internal medicine.