Document Type

Presentation

Publication Date

Fall 10-5-2026

Abstract

Background: Hormonal contraceptives are widely used for pregnancy prevention and management of gynecologic conditions. Because these methods alter endocrine function, many women worry that prolonged use may make it harder to become pregnant after stopping. This review examines current evidence on fertility recovery following long-term hormonal contraceptive use.

Objective: To evaluate evidence regarding:

  • Return to fertility after discontinuation
  • Differences among contraceptive methods
  • Effects on ovarian reserve markers (AMH and AFC)
  • Long-term reproductive outcomes
  • Clinical implications for patient counseling

Methods:

  • Design: Narrative literature review
  • Databases: PubMed/MEDLINE, Embase, Web of Science, Google Scholar, hand search of Fertility and Sterility
  • Search Period: December 2025 – July 2026
  • Included: 22 peer-reviewed studies – systematic reviews, meta-analyses, cohort, case-control, and cross-sectional studies
  • Primary Outcomes: Time to pregnancy, return to ovulation, ovarian reserve markers (AMH, AFC), ART/IVF utilization


Conclusions:

  • Long-term hormonal contraception does not appear to cause permanent infertility
  • Fertility recovery varies by contraceptive method
  • DMPA is associated with the greatest temporary delay
  • Ovarian reserve markers may be transiently suppressed but generally recover after discontinuation
  • Additional prospective studies evaluating women with >10–15 years of continuous use are needed

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