Time to fertility return after discontinuation of Intra-uterine contraceptive device: A systematic review and meta-analysis

Background: Time to fertility return and rate of pregnancy after discontinuation of contraceptive is important to provide effective family planning counseling on the method-specific choice and designing a strategy to avert such concerns and problems. The aim of this study was to determine the time to fertility return and rate of pregnancy after discontinuation of Intra-uterine contraceptive. Methods: The review was conducted through a systematic search of published articles in English language between 1967-2017. Information was extracted using a standardized form of Joana Brigg's Institute guidelines. After cleaning and sorting, analysis was performed using STATA version 11. Heterogeneity was assessed by the I-2 and publication bias through funnel plot. Results: A total of 27 studies with 8,037 women who discontinued contraceptive methods for pregnancy desire were included for analysis. The pooled time interval from contraceptive discontinuation to conception was 3.1 months for Intra-uterine contraceptive device. On the other hand, the pooled pregnancy rate was 84.5% at one year and 90% at two years after Intra-uterine contraceptive device removal. Conclusion: Intra-uterine contraceptive users experienced a slight delay in fertility return compared with those who did not use contraception but not sustained in the long term. This study recommends a family planning counseling approach that includes time for fertility return after discontinuation to avoid confusion of contraceptive users.