A 31-year-old woman who received two children by caesarean delivery wants a reversible method now but plans another pregnancy in about 2 years. She is concerned about how quickly fertility returns after stopping contraception. Which method is associated with the LONGEST average delay in return of fertility?

• A Combined oral contraceptive pills
• B Levonorgestrel-releasing intrauterine system
• C Copper-T 380A intrauterine device
• D Depot medroxyprogesterone acetate injection ✓

Explanation

Depot medroxyprogesterone acetate suppresses ovulation through sustained hypothalamic-pituitary inhibition, and because the drug depot persists in muscle after the last injection, return of ovulation averages 6 to 9 months and may extend up to a year, the longest delay of any reversible method. Pills and both intrauterine systems allow fertility to return within weeks of discontinuation. This delay is exactly why DMPA suits women wanting long spacing rather than near-term conception.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.