Contraception Needed, Even for Former IVF Couples

A leading Australian fertility specialist has highlighted the importance of contraception for women who have had difficulty in conceiving or undergone IVF.

President of Family Planning NSW and Sydney IVF gynaecologist, Dr Devora Lieberman, said despite her advice sounding contradictory, it was timely in light of new survey data(1) that has confirmed what has long been understood by specialists.

Dr Lieberman also took the opportunity to highlight that it was a surprise contraception is not usually thought of for women who've had difficulty in conceiving, those who've undergone IVF cycles or, women who have delivered an IVF baby.

"Unless a woman is sterile - or completely infertile - she may still have a chance of conceiving; I never say never! In other words, given enough time, a woman may conceive if her chance of getting pregnant is not zero. Of course, it then becomes a question of 'how much time'," said Dr Lieberman.

"Should a couple seek medical help to achieve pregnancy, it's wise they consider the need for contraception at an appropriate stage, especially after birth. I'd recommend women see their GP, local family planning clinic or visit educational websites for more information on contraception.

"The website has information on contraceptive options to suit women's lifestyles as well as links to Family Planning Australia websites in each state and territory," she said.

According to Dr Lieberman, there are varying degrees of fertility which can reduce the monthly chance of pregnancy. "We find that problems in conceiving arise when there's a major reproductive condition such as blocked fallopian tubes, a very low sperm count or when several mild causes are found, especially in combinations. Male-factor infertility accounts for about 40% of cases.(2) Also, in around 20% of cases, an obvious reason for infertility cannot be established.(3)

Reinforcing the need for contraception, Dr Lieberman added that she was aware of cases in which women have had IVF cycles or an IVF baby, yet a subsequent child was conceived naturally. "As these couples did not realise the importance of using birth control post-baby, the result - another baby sooner rather than later - has had a significant impact on their lives," she said.

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(1) Contraception, Relationships and Sexuality survey: July 2009. Based on a self completion survey of 1,000 women and men nationally aged between 18 and 45 years, compiled by independent researcher StollzNow Research.
(2) Lippincott Williams, Wilkins, Professional Guide to Diseases, 2005
(3) M Sara Rosenthal, The Thyroid Sourcebook, 2008
This survey was commissioned by Schering-Plough, with Sydney IVF providing input on selected questions.
This is the third stage of data to be released from the survey.

Case Study - Rose Evans

IVF patient and mother of four, Rose Evans, 43, says that women need to be aware of the need for contraception, even if - as with her situation - they have experienced difficulties in conceiving.

While Ms Evans has four children, aged 16, 13-and-a-half, four and two-and-a-half, she says becoming a Mum was not a smooth journey.

She has had eight pregnancies including two IVF cycles and four miscarriages - one prior to the birth of each of her children, who were finally conceived naturally.

"I'm proof that when it comes to reproduction, you never know how things will turn out.

"My second husband and I wanted to expand our family beyond the two children we had at the time, but didn't realise how difficult it would be. We tried for several years to have a baby and, during that time, even the IVF cycles led to miscarriage. It was devastating.

"Almost nine years after my second child, I had another, which was soon followed by my last child," said Ms Evans.

She added that between her third and fourth child, she did not use any form of contraception thinking that achieving pregnancy again would be impossible. "We so desperately wanted another child and I was very aware that my body was getting older.

"However, I was shocked to fall pregnant just four months after having my third child; had I been using contraception I would have been able to 'space out' my children.

"While I was overjoyed at that pregnancy, I was concerned about having another child so soon but, clearly, it was not meant to be as, sadly, I miscarried," she said.

Two months after her fourth miscarriage, Rose was pregnant again with her last child. Ms Evans added, "When it comes to contraception, it's also important for women to canvass their options. When I was younger, I took the pill and now that I have a different schedule with four active kids I'm seeking other options that fit around my lifestyle."