Effect of Contraceptives on Fertility

Pregnancy and childbirth carry risks of morbidity and mortality. Although the contraceptives that couples use to avoid pregnancy have their own health risks, they also have substantial noncontraceptive health benefits. Information about these risks and benefits is necessary for informed decision making. Oral contraceptives, for example, not only prevent pregnancy, but they also reduce the risk of endometrial and ovarian cancer and protect against acute pelvic inflammatory disease and ectopic pregnancies. However, oral contraceptives increase the risk of cardiovascular disease. IUDs provide effective contraception but increase the potential for infection in certain high-risk groups. Barrier methods of contraception provide less effective contraception, but they protect against sexually transmitted infections including human immunodeficiency virus (HIV). The importance of the noncontraceptive benefits and risks of contraceptives varies among societies because of variations in the prevalence of the diseases involved. In this review we will discuss evidence on the effectiveness and health consequences of specific contraceptive methods on fertility.