Depo-Provera Effect on Long-Term Fertility

Depo-Provera's effect on long-term fertility

Depo-Provera is a contraceptive given to women in the form of a shot once every three months. Doctors and fertility specialists agree it's an extremely effective form of birth control, but is it too effective? And are women being properly educated about all the possible effects especially when it comes to future fertility?


A viewer e-mailed FOX21 News concerned about her inability to get pregnant after receiving the Depo Provera birth control shot for several years. She struggled with other contraceptive methods before finding Depo-Provera, which worked until she wanted to have more children. She has been off the shot for a year and has had no luck getting pregnant, but what's worse is she said her doctor never told her about how long it can take once you stop the shot for ovulation to return to normal. The patient product labeling for Depo-Provera discloses that because "Depo-ProveraContraceptive Injection is a long-acting birth control method, it takes some time after your last injection for its effect to wear off. Based on the results from a large study done in the United States, of those women who stop using Depo-Provera Contraceptive Injection in order to become pregnant, about half of those who become pregnant do so in about 10 months after their last injection; about two-thirds of those who become pregnant do so in about 12 months, about 83 percent of those who become pregnant do so in about 15 months, and about 93 percent of those who become pregnant do so in about 18 months after their last injection." Dr. Shona Murray, fertility specialist at ADVANCE REPRODUCTIVE MAGAZINE said while Depo-Provera can't make a woman infertile, it can mask other fertility problems. "There are other reasons for having irregular cycles that might get missed because it's being put down as just being on Depo-Provera." 

- The Monthly Injectable Contraceptive -
Cyclofem® represents one of the most modern regular hormonal contraceptives. It belongs to the new class of CICs, Combined Injectable Contraceptives. This group name classifies hormonal contraceptives administered by intramuscular injection. The term "combined" indicates that these injectables contain both a progestin and an estrogen.
A CIC like Cyclofem® has the progestin component Medroxy - Progesterone - Acetate (MPA) in common with progestin-only injectables, however, the progestin dose received over time is much lower with Cyclofem® than with these progestin-only injectables. A basic difference between CIC's and progestin-only products is the presence of estrogens; the estrogen is designed to improve the control of the menstrual cycle so that regular menstrual bleedings are observed, which is an important aspect for many women when it comes to the choice of their contraceptive.
As the CIC Cyclofem® is a combined hormonal contraceptive, also many oral contraceptives are combined hormonal contraceptives, COC's, combined oral contraceptives. From a safety point of view the most important difference between the two classes of contraceptives is the presence of a "natural" estrogen in Cyclofem® versus synthetic estrogens in COC's.It is now recognized that natural estrogens have very favorable effects on lipid metabolism and cardiovascular function. Estradiol has direct effects on the arterial wall and on various stages of atherosclerotic plaque formation, resulting in an increase of tissue blood flow and in an anti-atherosclerotic effect. For an in-depth fact sheet about CIC use please see the chapter on CIC's in the latest edition of the WHO Medical Eligibility Criteria for Contraceptive Use.
The brand names that the Concept Foundation registered internationally for its combined injectable contraceptive are Cyclofem®, Cyclofemina®, and Novafem®. Pharmacia Pharmaceuticals, Peapack NJ, had launched its product under the license from Concept Foundation with their own brand name Lunelle® in the US market.


Depo Provera (also known as DMPA or Depot Medroxyprogesterone Acetate) is a hormone injection that lasts for 3 months to prevent pregnancy. The injection contains synthetic progesterone and no estrogen. It is usually given in the the arm, hip, upper thigh, or abdomen, delivering a high level of progesterone into the body. Depo Provera stops the ovaries from releasing eggs. Depo Provera causes the cervical mucus to thicken and changes the uterine lining, making it harder for sperm to enter or survive in the uterus. These changes prevent fertilization. Depo Provera is a very private form of birth control because it cannot be seen on the body and requires no home supplies. It does, however, require a clinic appointment every 3 months.
Depo Provera is 97-99.7% effective as birth control. It does not protect against reproductive tract infections, including HIV/AIDS. There are some serious health risks with Depo Provera, so be sure to get all the facts in advance.
The first shot of Depo Provera is usually given during or a few days after the start of a menstrual period. After 24 hours, the shot is effective birth control for the next 13 weeks. Many women find it useful to schedule their next shot slightly earlier than necessary; if something prevents them from making their appointment, there will be a window of opportunity to receive their next shot.
If you are more than a week late for your shot, use a backup method of birth control for the next two weeks. If you are more than a week late and you have had unprotected sex since your last shot, consider taking a pregnancy test before receiving the next dose.
Your Health       
Due to the risk of serious health problems, women with the following conditions should not use Depo Provera.
    * Unexplained vaginal bleeding
    * Known or suspected pregnancy
Depo Provera may not be recommended for women who are planning on becoming pregnant in the near future, are concerned about weight gain, have liver disease, gallbladder disease, or a history of depression. Study the risks and talk with your health care practitioner.

Emergency Contraception

Emergency Contraception
What is emergency contraception?
Emergency contraception is a form of birth control. You can use this method if you have had unprotected sex. For example, if your regular birth control fails (the condom breaks during sex), if you forget to take your birth control pills or if you have sex without using any birth control.
There are 2 types of emergency contraception. With the first, you take special doses of birth control pills. With the other, an intrauterine device (also called an IUD) is placed in your uterus (or womb).
How do I use emergency contraception?
The first kind of emergency contraception, sometimes called the "morning-after pill," is taken in two doses. You can start taking this kind of emergency contraception right away after having unprotected sex. The sooner you take it, the better it works, but you can take the first dose within 120 hours (5 days)after having unprotected sex. You take the second dose 12 hours after the first. Your doctor may tell you about other ways of taking this medicine.
There is a brand of pills made just for emergency contraception. It is called Plan B (levonorgestrel). Plan B contains only progestin.
The U.S. Food and Drug Administration also has said that some brands of regular birth control pills are safe for emergency use. The number of pills you take in each dose depends on which brand of pills you are using. To learn more about which pills are safe for emergency use, talk with your doctor.
An IUD that is placed in your uterus within 7 days after unprotected sex also can be used as emergency contraception. An IUD is a small device that can be left in your body for 5 to 10 years. It will prevent pregnancy during that time.

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