Improving the quality of sexual and reproductive health and rights (SRHR) through pre-service training, research, and evidence-based clinical care delivery in Sub-Saharan Africa

1Tenonfo Tesse Franky Maxwell,123Fouedjio Jeanne Hortence
1Faculty of Medicine and Pharmaceutical Sciences of the University of Dschang,Cameroon
2Gynecology and Obstetrics Unit of the Central Hospital of Yaounde,Cameroon
3 Department of Gynecology and Obstetrics,Faculty of Medicine and Biomedical Sciences, University of Yaounde 1, Cameroon.
Correspondant : Tenonfo Tesse Franky Maxwell ; +237 653099297 ; tenonfomax@gmail.com

BACKGROUND
Global concerns exist regarding fertility return after
discontinuing long acting reversible contraceptives (LARCs). Limited evidence in sub-saharan Africa,including cameroon on a potential link between the usage of long acting reversible contraceptives and a delay to return to fertility after discontinuing long acting reversible contraceptives has led to speculations on modern contraceptives delaying return to fertility or causing infertility. Our research assesed the return to fertility after discontinuing long acting reversible contraceptives among women attending 2 obstetric units in cameroon.
METHODS
We conducted an analytical cross-sectional study from febuary 2024 to april 2025 among women aged 15-49 years who concieved after LARC(CopperIUCD,Implants) discontinuation. Ethical clearance was obtained and Data collection done using pretested and structured questionnaire. Bivariate and multivariate binary logistic regressions were done to determine the predictors of a delayed fertility return.
RESULTS
Among 218 participants,the proportion of fertility return after discontinuing LARCs within 12 months was 84.4% (95% CI :79.5%-89.5%). In multivariate binary logistic regression, Participants aged 35years (AOR=3.429, 95% CI :1.469-8.799) and a duration of usage of LARCs above 36months (AOR=2.913, 95% CI :1.311-6.473) were positively associated with a delay in return to fertility (above 12months).
CONCLUSION
This study reinforces high rate of fertility return following LARCs discontinuation, however it highlights the need for enhanced counseling,particularly for women of advanced reproductive age and those with extended use of LARCs,to address misconceptions.Intergrating fertility awareness into family planning services in cameroon is critical to promoting informed contraceptive choices.
KEY WORDS
Return to fertility, Long-acting reversible contraceptives, discontinuation, infertility, copper intra-uterine contraceptive device, Implants and Reproductive health