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No, hormonal contraceptives don’t ‘kill’ egg cells, and birth control not only for married people who don’t want more kids

“If you are a single lady, please hear me loud and clear stop taking tablets or injection to prevent pregnancy,” begins a message posted several times on Facebook, particularly in Nigeria, in late September 2020. “When you are still dating, how could you involve yourself in family planning when you are still single?”

Contraception, the message claims, is “made only for the married couples who are no longer interested in having more kids” – and causes infertility. Most versions of the message show a blister pack of Postinor 2, the brand name of an emergency hormonal contraception pill whose active ingredient is  levonorgestrel

“Some ladies always take injection that last 6months or 1yr. One thing you don't know about these drugs is that they are only made to kill your eggs and immobilize your hormones,” the message reads.

“Ladies, protect your eggs, protect your womb and protect your fetus,” it ends. It’s been viewed more than 400,000 times so far.

Female ovaries produce egg cells, known as ova or oocytes. Do hormonal contraceptives cause infertility by killing these eggs? We checked. 

Hormonal contraceptive pills and injectables

The message refers to three types of hormonal contraceptive: the daily contraceptive, the emergency contraceptive and the injectable contraceptive.

The combined oral contraceptive pill, known simply as the pill, is taken daily and stops ovulation – the release of a mature egg from the ovary – by stimulating production of the hormones oestrogen and progesterone. These hormones also thicken the mucus of the womb, making it harder for sperm to penetrate, and thin the womb’s lining, making it harder for an egg to successfully implant.  When taken properly, the pill is over 99% effective at preventing pregnancy. 

Levorongestral is an emergency contraceptive effective when taken within 72 hours of unprotected sex. It prevents a fertilised egg from implanting in the uterus. 

Injectable contraceptives include Noristerat, Depo Provera and Sayana Press. They release progesterone into the bloodstream, preventing ovulation and thinning the lining of the uterus. 

Injectables can be effective for eight to 13 weeks, depending on the type used. They can also cause changes to periods and temporarily stop them altogether. 

But do these contraceptives cause infertility?

Most women become pregnant after stopping hormonal contraceptives

Hormonal contraceptives prevent ovulation, but they do not kill egg cells in the ovaries. 

A 2018 meta-analysis – an analysis of results published in several research papers – assessed the fertility of women after they had stopped using contraception. It looked at 22 studies involving a total of 14,884 women. Some of these women had stopped using hormonal contraception, and others no longer used non-hormonal, mechanical methods such as condoms and the copper intrauterine device

Out of the 14,884 women in the study, an average of 83.1% became pregnant within 12 months after they stopped using contraception. The study reported slightly lower rates of pregnancy among women who had used hormonal instead of mechanical contraception, but did not find this difference to be statistically significant. 

“This difference may be due to the fact that hormonal contraceptives commonly take months to clear from the body which results in temporary delay in resumption of pregnancy for months,” the researchers concluded

Another study endorsed by the US Food and Drug Administration found that 114 out of 188 women who had stopped injectable contraceptives became pregnant. It concluded: “The median time to conception for those who do conceive is 10 months following the last injection with a range of four to 31 months, and is unrelated to the duration of use.” 

Other studies and sources have repeatedly shown that while there is a delay in return to fertility, most women who stop using hormonal contraceptives do eventually get pregnant. 

Hormonal contraceptives have not been found to cause infertility. The contraceptives are not designed to “kill” egg cells – instead, they temporarily halt ovulation. Most users are able to conceive normally a few months after they stop using these contraceptives. – Naledi Mashishi


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