A 26-year-old woman receives depot medroxyprogesterone acetate 150 mg intramuscularly every 12 weeks. She stops injections to plan pregnancy. Compared with other reversible methods, what should she be counselled regarding return of fertility?
- A Fertility returns within 1 month of the last injection
- B Fertility never returns without ovulation induction therapy
- C Return of ovulation may be delayed up to 9 to 12 months after the last injection ✓
- D Delay in conception equals exactly the duration of DMPA use
Correct answer: C. Return of ovulation may be delayed up to 9 to 12 months after the last injection
Explanation
Depot medroxyprogesterone suppresses the hypothalamic-pituitary axis and is stored in muscle, so ovulation resumes a median of about 6 months after the last dose, with delays up to 9 to 12 months in some users. This is the longest return-to-fertility delay among reversible contraceptives and must be discussed before choosing the method. Fertility does return spontaneously and the delay does not correlate simply with duration of use.
Reference: Williams Gynecology, 4th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.