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Birth control: can it affect future fertility?

by Toni Weschler

question
I have heard that different methods of birth control can affect your ability to conceive. Can you elaborate?

answer
The two forms of birth control that can pose the most problems for future fertility are the IUD and all forms of hormonal birth control. In the case of the IUD, the insertion of the device itself, as well as subsequent exposure to sexually transmitted diseases, put women at greater risk of developing pelvic inflammatory disease (PID). During insertion, bacteria can enter the sterile environment of the uterus and cause a serious infection. The notorious discontinued Dalkon Shield had a twisted string that acted as a type of wick drawing bacteria from the non-sterile vagina to the sterile uterus. This often resulted in PID, wreaking havoc on the woman's fallopian tubes.

In the case of the Pill, many women find that it takes a long time to resume a regular cycle after having been on hormones. Once women start their cycle again they tend to revert back to their former pattern. So, for example, if you had an irregular cycle before going on the Pill, your cycle would probably revert back to that irregular pattern.

A more insidious problem with the Pill is the undetectable effect it has on the cervical crypts within the cervix. These channels produce the healthy, slippery cervical fluid necessary for conception to occur. The Pill often destroys the cells that line the channels, preventing a woman from producing the wet cervical fluid which allows the sperm to swim through the cervix around ovulation. Often a woman's body will be able to regenerate the destroyed cells, but if not, she may need to resort to intrauterine insemination (IUI) in order to bypass the ‘biological gate’ which is preventing the sperm from reaching their prized destination of the egg.

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