Stoddard Amy M, Xu Hanna, Madden Tessa, Allsworth Jenifer E, Peipert Jeffrey F
* Department of Obstetrics and Gynecology, University of California , Los Angeles, CA , USA.
Eur J Contracept Reprod Health Care. 2015 Jun;20(3):223-30. doi: 10.3109/13625187.2015.1010639. Epub 2015 Mar 9.
Despite high efficacy, only 7.7% of women in the United States currently using contraception use an IUD. There is little published contemporary data about fertility rates after IUD use, especially in nulliparous women and women using the hormonal IUD.
We recruited sexually active women 18 to 35 years of age enrolled in the Contraceptive CHOICE Project who had discontinued a contraceptive method and desired pregnancy.
In this pilot project, we enrolled 69 former IUD users (19 copper and 50 levonorgestrel) and 42 former non-IUD users. Pregnancy rates at 12 months were similar between the two groups; 81% of IUD users became pregnant compared to 70% of non-IUD users (p = 0.18). In the Cox model, there was no difference in the time to pregnancy in IUD users compared to non-IUD users (HRadj 1.19, 95% CI 0.74-1.92). African American race was the only variable associated with reduced fertility (HRadj 0.40, 95% CI 0.24-0.67).
We found no difference in 12-month pregnancy rates or time to pregnancy between former IUD users and users of other contraceptive methods. However, there was a clinically and statistically significant reduction in fertility in African American women.
尽管宫内节育器(IUD)有效性高,但目前在美国使用避孕措施的女性中,只有7.7%使用IUD。关于使用IUD后的生育率,尤其是未生育女性和使用激素IUD的女性,当代公开数据很少。
我们招募了参与避孕选择项目、年龄在18至35岁之间、有性生活、已停用一种避孕方法且渴望怀孕的女性。
在这个试点项目中,我们招募了69名 former IUD使用者(19名使用铜质IUD,50名使用左炔诺孕酮IUD)和42名 former非IUD使用者。两组在12个月时的怀孕率相似;81%的IUD使用者怀孕,而非IUD使用者为70%(p = 0.18)。在Cox模型中,IUD使用者与非IUD使用者相比,怀孕时间没有差异(校正风险比1.19,95%置信区间0.74 - 1.92)。非裔美国人种族是与生育力降低相关的唯一变量(校正风险比0.40,95%置信区间0.24 - 0.67)。
我们发现 former IUD使用者与其他避孕方法使用者在12个月怀孕率或怀孕时间上没有差异。然而,非裔美国女性的生育力在临床和统计学上有显著降低。