A 26-year-old woman has been receiving depot medroxyprogesterone acetate (DMPA) injections for contraception for 18 months. She now wishes to conceive and has her last injection removed from the programme. What is the most accurate statement regarding return of fertility?
- A Ovulation typically resumes within 4 weeks of the last injection in the majority of users
- B Anovulation persists for at least 24 months after the last DMPA injection in most users
- C Return to fertility is delayed compared to cessation of combined oral contraceptives, with a median time to pregnancy of approximately 10 months from the last injection ✓
- D A washout period of 3 months is required before attempting conception due to teratogenic risk
Correct answer: C. Return to fertility is delayed compared to cessation of combined oral contraceptives, with a median time to pregnancy of approximately 10 months from the last injection
Explanation
DMPA is associated with a longer delay in return of fertility compared with other contraceptive methods. The median time to pregnancy after the last injection is approximately 10 months, and it can take up to 18 months for some women. This is significantly longer than the return seen with combined oral contraceptives or copper IUDs. Option A overestimates the speed of return; option B exaggerates the duration.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.