A 27-year-old para 1 has received depot medroxyprogesterone acetate injections for four years and wishes to conceive. After stopping the injections she should be counselled that ovulation may be delayed for up to:

• A 1 month
• B 3 months
• C 6 months
• D 12 months ✓

Explanation

Depot medroxyprogesterone acetate has the longest delay in return of fertility of any reversible contraceptive; ovulation and menstruation may take up to 12 months to resume after the last injection, because intramuscular depots continue releasing drug for months. Three months is merely the dosing interval between injections and should not be confused with the recovery time. Women planning pregnancy in the near future are therefore steered toward shorter-acting progestogen methods. This counselling point is a favourite examination fact and reflects Indian textbook convention as well.

Reference: Park's Textbook of Preventive and Social Medicine, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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