RETURN OF FERTILITY FOLLOWING DISCONTINUATION OF NORPLANT .2. SUBDERMAL IMPLANTS - ICMR TASK-FORCE ON HORMONAL CONTRACEPTION

A total of 627 women who had discontinued the use of the Norplant-II i mplants for various reasons and were exposed to the risk of pregnancy were followed-up for two years for return of fertility. The cumulative conception rates in women who had discontinued due to planning pregna ncy were 80.3 per 100 women at one year and 88.3 per 100 women at two years. The majority of women who did conceive (90 percent), had fall-t erm normal live births; about 4 percent of women had spontaneous abort ions, the remaining 6 percent decided on elective termination of pregn ancy (ETP). The cumulative conception rates in women who discontinued due to bleeding irregularities and 'other reasons' were 64.5 and 55.8 per 100 women at one year and 77.9 and 75.1 per 100 women at two years , respectively. These rates were significantly lower as compared to th ose observed in women who discontinued due to planning pregnancy. A la rge proportion, about 40 percent, of women who conceived after discont inuation of the method due to bleeding irregularities and ''other reas ons,'' opted for ETP indicating that many women in these two groups,di d not desire another child and that such women need to be counselled f or adopting another method of contraception. The spontaneous abortion rates observed in ex-users of Norplant-II implants (1.7 to 4.4% pregna ncies) were comparable to the spontaneous abortion rates prior to Norp lant-II implant use (3.6% pregnancies) indicating that ex-users of Nor plant-II implants were not at a higher risk of spontaneous abortion. T here was no association between the pregnancy rates and either duratio n of Norplant-II implants use or bleeding patterns during the three mo nths prior to discontinuation of the method in this sample. However, t here was a delay in return of fertility in women aged more than 30 yea rs as compared to those who were below the age of 30 years. The study indicates that the return of fertility was not impaired in ex-Norplant -II implant users who were planning pregnancy. In addition, those wome n who continued with the pregnancy until term delivered full-term norm al babies in all the study groups.