Fertility in older women following removal of long-term intrauterine devices in the wake of a natural disaster

Contraception. 2013 Apr;87(4):416-20. doi: 10.1016/j.contraception.2012.11.002. Epub 2012 Dec 13.

Abstract

Background: In order to evaluate the effect of long-term intrauterine device (IUD) use on female fertility, we interviewed 2301 women who lost children in the 2008 Wenchuan earthquake in China, which prompted IUD removal.

Study design: A clinical retrospective survey.

Result: Five hundred and twenty-four women were lost to follow-up, and data from the remaining 1770 women were analyzed. The completed questionnaires revealed that 80.11% (1418/1770) became pregnant following IUD removal and about 88% (1256) of whom conceived within 1 year. Among women with different durations of IUD use, pregnancy rates and miscarriage rates were as follows: <5 years, 89.77% and 4.27%; 6-10 years, 81.10% and 10.19%; and >10 years, 75.20% and 12.98%, respectively. Age, duration of IUD use, a history of a previous miscarriage and abnormal menstruation before the earthquake were independently associated with reduced fertility, but a higher gravidity pre-earthquake was associated with a higher conception rate.

Conclusion: Long-term IUD use in older women had a high rate of pregnancy after removal of IUD, but with an increased risk of fertility problems.

MeSH terms

  • Abortion, Spontaneous / epidemiology
  • Adult
  • Age Factors
  • Aging / physiology
  • China / epidemiology
  • Disasters*
  • Earthquakes*
  • Female
  • Fertility*
  • Humans
  • Intrauterine Devices / adverse effects*
  • Middle Aged
  • Pregnancy
  • Pregnancy Rate
  • Retrospective Studies
  • Time Factors
  • Young Adult