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  • Title: Return of fertility after discontinuation of the once-a-month injectable contraceptive Cyclofem.
    Author: Bahamondes L, Lavín P, Ojeda G, Petta C, Diaz J, Maradiegue E, Monteiro I.
    Journal: Contraception; 1997 May; 55(5):307-10. PubMed ID: 9220228.
    Abstract:
    The objective of this study was to evaluate the return of fertility in women who used Cyclofem as a contraceptive method during the introductory studies conducted in Brazil, Chile, Colombia, and Peru. From these four cohorts, 101 women were eligible for the study. Thirty-one were not included in the study either because they refused to be interviewed, had initiated another contraceptive method the month after discontinuation, or were unable to be contacted. A total of 70 women were included in the study. Our results showed that the return to fertility rate after the discontinuation of Cyclofem was 1.4 per 100 women at the end of the first month and reached 82.9 at one year. More than 50% were pregnant at 6 months. Fifty-one (94.4%) pregnancies ended in a live birth, two were spontaneous first trimester abortions, and one was a hydatidiform mole. Return of fertility was not related to the woman's age at the time of discontinuation, her weight, or the number of Cyclofem injections. In conclusion, fertility is restored by 1 month following Cyclofem discontinuation. Users and potential users should be counseled regarding the rapid return of fertility after discontinuing this method of contraception. Cyclofem, a monthly injectable contraceptive containing 5 mg estradiol cypionate and 25 mg medroxyprogesterone acetate, has been registered in several Latin American countries; however, the return to fertility after method discontinuation has not been investigated. To address this issue, 70 women were followed who had participated in introductory studies in Brazil, Chile, Colombia, and Peru during 1992-94 and who then discontinued injectable use to achieve pregnancy. The mean number of Cyclofem injections was 7.1 (range, 1-19). The fertility rate was 1.4 at the end of the first month after Cyclofem discontinuation, 52.9 after 6 months, and 82.9 at 12 months. 55 pregnancies (94.8%) ended in live-term births, with no congenital malformations; there were 2 spontaneous abortions in the first trimester. The number of months required to become pregnant was not significantly associated with maternal age, body weight, number of injections, or country site. The return to fertility for this method is comparable to that following discontinuation of copper IUDs, barrier methods, and oral contraceptives. Since information on return to fertility is essential to informed choice, these findings should be incorporated into educational and counseling materials for providers and potential acceptors of this new contraceptive method.
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