Fertility in older women following removal of long-term intrauterine devices in the wake of a natural disaster

BackgroundIn order to evaluate the effect of long-term intrauterine device (IUD) use on female fertility, we interviewed 2301 women who lost children in the 2008 Wenchuan earthquake in China, which prompted IUD removal.Study DesignA clinical retrospective survey.ResultFive hundred and twenty-four women were lost to follow-up, and data from the remaining 1770 women were analyzed. The completed questionnaires revealed that 80.11% (1418/1770) became pregnant following IUD removal and about 88% (1256) of whom conceived within 1 year. Among women with different durations of IUD use, pregnancy rates and miscarriage rates were as follows: < 5 years, 89.77% and 4.27%; 6–10 years, 81.10% and 10.19%; and > 10 years, 75.20% and 12.98%, respectively. Age, duration of IUD use, a history of a previous miscarriage and abnormal menstruation before the earthquake were independently associated with reduced fertility, but a higher gravidity pre-earthquake was associated with a higher conception rate.ConclusionLong-term IUD use in older women had a high rate of pregnancy after removal of IUD, but with an increased risk of fertility problems.