How to get pregnant after hormonal contraceptives. Pregnancy after taking birth control

It would seem obvious that such questions should be addressed directly to the doctor. However, often future parents prefer to look for information "among the people" - from friends, acquaintances or on the Internet. Unfortunately, in this case, instead of an adequate answer to the question, there is a high risk of running into all sorts of "folk wisdom" - various myths and prejudices related to the topic of "pregnancy planning after treatment."

Myth No. 1. After any surgical operation, you must wait at least a year before pregnancy!

Such a peremptory statement can only be heard from a person who is completely ignorant of medical matters. A surgical operation is not a disease, not a diagnosis, but only a designation (and a very general one!) of a type of medical intervention in which a surgical dissection of tissues is performed. For example, surgical intervention is equally the removal of an inflamed appendix, and the opening of a boil by a surgeon in a clinic. Obviously, these two surgical interventions have very different effects on health and, accordingly, recommendations for planning a pregnancy after surgery will also clearly differ! Surgical operations are large and small, planned and emergency, abdominal (that is, with penetration into the abdominal cavity), multi-stage (when one operation is divided into several successive stages with an interval of several minutes, days or even months), plastic, cosmetic and many more. other types. After some interventions, the restoration of functions can take many years, and after others, a couple of hours or days are enough. Moreover, there are surgical interventions carried out as part of the treatment of infertility, for example, restoration of patency of the fallopian tubes, removal of ovarian cysts or venoplasty for varicocele (varicose veins of the testicles), after which it is recommended to start trying to conceive in the next cycle! Operations are subdivided according to the area and volume of intervention, as well as according to indications for intervention; from this, as well as from the course of the operation and the postoperative period, the time required for a person to fully restore health before planning conception depends. The necessary recommendations for further family planning can be obtained from the doctor who performed the operation and observation in the postoperative period. If this is not possible (for example, due to the prescription of years or due to moving to another city), the issue of a planned pregnancy should be discussed with a family planning specialist, providing him with a discharge postoperative epicrisis (a medical report given to the patient upon discharge after surgery).

Myth number 2. You can only plan a pregnancy a couple of months after any treatment.

This statement is no less unfounded than the previous one, but it is also harmful! The myth is based on the opinion that all drugs are harmful to the child, so before conception, any previously taken drugs should be immediately discontinued. Such "folk wisdom" is not only wrong, but also dangerous: following it, you can jeopardize the very fact of pregnancy and the health of the unborn child. If before the onset of pregnancy, one of the future parents constantly took certain drugs, then he has chronic diseases that require treatment. Moreover, sometimes such treatment is required constantly, for example, with bronchial asthma, eczema or arterial hypertension (a tendency to increase pressure). At the same time, the planning of conception for such a chronic patient may not be contraindicated at all, and drug therapy is just necessary for the successful onset and course of pregnancy. In this case, unauthorized withdrawal of drugs can exacerbate chronic pathology and lead to a general deterioration in the health of future parents. Exacerbation of the disease after a sudden cessation of treatment is also facilitated by a general decrease in immunity in the event of pregnancy. It is especially dangerous to arbitrarily cancel drugs that correct blood pressure, work of the heart, lungs, kidneys and liver, as well as drugs prescribed by an endocrinologist (treatment of diabetes mellitus, diseases of the adrenal glands, thyroid and pancreas, etc.).

The course of pregnancy and the development of the baby directly depends on the health of the expectant mother. During pregnancy, a double burden falls on the mother's body. Drugs prescribed by a doctor for the treatment of chronic diseases help the expectant mother to cope with the increased load and safely endure the baby. Therefore, it is not necessary to arbitrarily cancel the therapy prescribed by the doctor before the onset of pregnancy. In the presence of chronic diseases, it is worthwhile in advance, at the stage of pregnancy planning, to discuss with your doctor the possibility of taking certain drugs before conception and in the first days of pregnancy. And at the first signs of an “interesting situation”, visit a specialist again to correct the therapy and dosage of drugs in connection with the onset of pregnancy. The doctor will replace some drugs with analogues that are not dangerous for mom and baby, for some drugs the dosage will gradually decrease. It is possible that the doctor will be forced to cancel some drugs in the interests of the fetus. However, only a competent specialist can make a decision to cancel, replace or reduce the dose of a previously prescribed drug; unauthorized withdrawal of drugs can affect the health of the mother and fetus much worse than taking the most "harmful" drugs.

The same applies to pregnancy planning after taking antibiotics - each antibacterial drug has its own accumulation and elimination time from the body, its own level of harmfulness with a potential effect on conception. There are antibiotics that do not cause significant harm to germ cells, embryo and fetus. If necessary, they can even be prescribed during pregnancy. When taking such antibiotics, the interval before the planned conception is determined only on the basis of the recovery time of the body and microflora (after treatment with any antibacterial drugs, it is necessary to restore the normal flora of the intestines and genital tract). Other drugs in this group have a pronounced teratogenic (damaging the fetus) or toxic effect, their half-life products can remain in the blood for a long time, and sometimes it takes up to six months or even a year to recover after taking. The conclusion is obvious: it is possible to decide on the timing of pregnancy planning after taking antibiotics only with the attending physician.

Myth #3: You can't get pregnant right after you stop taking oral contraceptives.

Completely wrong statement. There are various types of hormonal drugs in this group. Some drugs are based on the suppression of ovulation of the egg, others affect the viscosity of the cervical mucus (mucus secretion that fills the lumen of the cervix), others inhibit the growth of the endometrium - the uterine mucosa, the thickness of which determines the possibility of implantation (attachment) of the fetal egg. Most modern oral contraceptives are combined, that is, they combine different types of hormones and give a complex effect of contraception. However, regardless of the exposure option, these drugs affect the body only directly during regular intake: when any of these drugs is canceled, menstruation should begin, followed by a normal menstrual cycle with full egg maturation, endometrial growth and cervical mucus permeability. Thus, after the completion of oral administration, there is no aftereffect (for example, the accumulation of harmful substances in the blood or pathological changes in the functioning of the organs of the reproductive system) that could pose a danger to the planned pregnancy. Moreover, drugs in this group are effectively used to treat various types of hormonal infertility. In some cases, taking oral contraceptives continues after the onset of conception - during the first trimester, drugs containing progesterone are prescribed to prevent and treat the threat of abortion in the early stages.

Myth № 4. You can plan pregnancy immediately after removing the IUD.

And in this case, everything is exactly the opposite. The advice is wrong again. The IUD, or intrauterine device, is a “female” method of contraception, to achieve which a special spiral made of medical steel coated with silver, gold or even platinum is inserted into the uterine cavity for a long time (year, 3 years, 5 years) (precious metals are used for prevention of purulent inflammation). The contraceptive effect is based on the rejection reaction, which is provoked by a foreign body (spiral) located in the uterus. During the entire period of wearing the spiral in the uterus, the process of aseptic (non-purulent) inflammation occurs, the tone of the uterus increases, the structure of the endometrium (the mucous membrane of the uterine cavity) partly changes: it is these factors that prevent the implantation of a fertilized egg in the uterus. Some IUDs are supplied with a capsule with a hormonal contraceptive that is constantly released in the woman's body while wearing the spiral, but the main effect of this method is still based on an inflammatory provocation in the uterus. In this regard, gynecologists do not recommend planning a conception earlier than 3 months after the removal of the IUD: it is necessary that the effects of prolonged aseptic inflammation be completely eliminated in the uterine cavity. Otherwise, during conception, the risk of developing a threat of interruption or even is significantly increased. The couple is recommended to use barrier methods of contraception (condoms, vaginal membrane, cervical cap) for 3 months, and before the planned conception, once again come for a consultation with a gynecologist for a re-examination, collection of tests and control ultrasound in order to confirm the completion of recovery processes in the uterus.

Myth No. 5. After a “failed” pregnancy, long-term treatment is always necessary.

This statement is erroneous due to its categorical nature: long-term treatment after an abortion may indeed be needed, but not always. The term "unsuccessful pregnancy" includes all options in which the pregnancy did not take place. There are many such options, and they differ greatly among themselves in terms of the reasons for development, course, completion, and consequences for the health of the expectant mother. The “unsuccessful” options include spontaneous abortion (miscarriage), non-developing or “frozen” pregnancy, when the growth of the embryo stops at any stage of development, ectopic pregnancy, artificial interruption (abortion) or stimulation of premature birth for medical reasons (fetal pathology, incompatible with life). Recommendations on the timing of planning a second pregnancy in each of these cases will vary significantly. For example, after a spontaneous miscarriage against the background of hormonal deficiency, it is possible to plan the next pregnancy after 3 months (provided there are no other pathologies and progesterone preparations are prescribed), and in the event of an ectopic pregnancy, it may take several years to treat and restore the body. The only thing that is the same for all cases of planning a second pregnancy after an “unsuccessful” one is the need for a thorough medical examination, which will help identify the causes of failure and avoid it in the future.

Myth No. 6. After interventions in the reproductive sphere, it is impossible to plan a pregnancy earlier than in 5 years

The history of the appearance of such a myth (it should be noted that it is very stable!) is quite understandable: it was this “waiting period” that doctors recommended after operations on the uterus, primarily after cesarean section, several decades ago. Such an impressive interval between surgery and a planned pregnancy was due to the time required for the complete resorption of the suture material used at that time, the formation of stable scars at the site of the incisions, and the duration of the recovery of the woman's body after a severe, traumatic operation. However, much has changed for the better in medicine and surgical technology since then: operations have become much less traumatic (for example, extracorporeal caesarean section with a vertical incision along the entire abdomen is practically not used now), modern suture material dissolves within a few weeks, postoperative scars due to with this, they became much more elastic (this significantly reduced the risk of uterine scar rupture during subsequent pregnancy and childbirth), the formation of a stable postoperative scar is completed on average already 1 year after the operation.

Many gynecological and urological interventions are now performed endoscopically (through the vagina and uterine cavity), endovascularly (intravascular technique) or laparoscopically (through micropunctures), which allows minimizing traumatic consequences for the body and significantly reducing the time required to fully restore health before the planned conception. Therefore, today the question is: “When can I plan a pregnancy after a cesarean?” - parents can hear the joyful answer of the doctor: “Yes, come back in a couple of years!” After some purely "male" and "female" surgeries performed to increase the chances of conception - for example, the treatment of varicose veins and dropsy of the testicles in men, blowing out the fallopian tubes and removing foci of endometriosis in women (benign growths of the endometrium outside the uterus), - you can plan conception after 2 months, and sometimes almost immediately after discharge. Of course, in each specific case, recommendations for a couple will be purely individual: the type of intervention, indications, volume and features of the course of the operation and the postoperative period, as well as the age and general health of the future parent who has undergone surgical intervention in the reproductive sphere, are important.

The instructions for such drugs usually write that conception can occur in the next cycle after the abolition of oral contraceptives. However, you need to understand that this is not always the case.

Much depends on the age of the woman, the characteristics of her body, the specific drug and its dosages.

Factors affecting the chance of conception

The essence of the use of oral contraceptives is to take synthetic analogues of female sex hormones - progesterone and estrogens. As a result, ovarian function is suppressed with the cessation of the ovulation process.

Normally, after giving up the pills, a fairly quick restoration of reproductive function occurs with the possibility of becoming pregnant after contraceptives.

However, it is important to understand that the body tends to get used to the intake of bioactive substances from outside. When the tablets are canceled, he may need a certain period of time to fully restore fertility.

Important factors that affect the rate of renewal of the possibility of conception are:

• The age of the woman. At 25, the process of normalizing the menstrual cycle can take 2 or 3 months, after 30 - about a year, at 35 and older - several years. That is why doctors advise women not to delay pregnancy.
• The duration of taking the tablets. If contraceptives have been used for several months, then normal ovulation may occur as early as the next cycle. But when a woman has been taking contraceptives continuously for years, it will take her much longer to normalize her reproductive function.
• Individual characteristics of the organism. Different women have different levels of hormones, some may have gynecological diseases, etc. One woman may need 1-2 months to stabilize the menstrual cycle, and the other - several years. Everything is individual, even if the age and duration of taking the drugs do not differ.

Therefore, when planning a pregnancy, you need to cancel oral contraceptives as early as possible, given that the body will need several months to recover.

Rebound effect (withdrawal syndrome)

Rebound effect is a term that is used in gynecology to characterize a compensatory increase in ovarian productivity after the abolition of a course of contraceptives. To combat some forms of infertility, doctors can purposefully use oral contraceptives.

At first glance, this may seem absurd. After all, a woman’s reproductive function already suffers, and here she is even more oppressed. However, it was found that with a short course of taking oral contraceptives (2-3 months) with their subsequent cancellation, a compensatory increase in ovarian activity is observed. They work better, which contributes to the normalization of the menstrual cycle with the stabilization of the ovulation process.

This is the essence of the rebound effect.. In most cases, it significantly increases the chance of getting pregnant after contraceptives. However, it must be remembered that this effect does not always work.

If infertility persists and ovulation does not occur, the woman may need other treatment. Usually, with endocrine infertility, ovulation stimulation is prescribed with hormonal drugs or pregnancy is achieved using assisted reproductive technologies.

Increasing the chance of successful conception

If a woman takes oral contraceptives on an ongoing basis, but has a desire to become pregnant in the near future, then she should remember a few nuances that will increase her chances of conception:

• Having canceled contraceptives, you should not immediately try to get pregnant. It is better to wait 1-2 months for the normalization of the menstrual cycle. The mucous membrane of the uterus and the ovaries themselves need a certain amount of time to restore their function.
• Live a healthy life. If alcohol and nicotine are consumed while taking contraceptives, this significantly reduces the chance of successfully conceiving a child in the future.
• Complete all necessary medical examinations. After the abolition of contraceptives, it is necessary to assess the state of reproductive health, assess the chances of conceiving and bearing a child. To do this, the hormonal background of a woman is examined, tests for infections are taken, an ultrasound scan of the pelvic organs is performed.

To increase the chances of success, it is desirable to carry out a full pregnancy planning. Consultation with a doctor and compliance with all his recommendations will allow you to achieve the desired goal as quickly as possible.

Pregnancy after other birth control methods

In addition to the variety of birth control pills, there are other types of contraceptives.

The most popular are:

• Contraception using barrier means (condom, vaginal diaphragm, uterine cap).
• The use of an intrauterine device (IUD).
• Natural contraception (lactational amenorrhea, coitus interruptus, calendar method).
• Chemical contraceptives (spermicides).

Most women can get pregnant after using birth control.

It is worth noting that pregnancy after refusing to use these methods of contraception occurs almost always without problems. An exception can be considered incorrect setting or removal of the intrauterine device (which is rare). In this case, a local inflammatory process may occur, which, until it is eliminated, will interfere with the normal process of conception and implantation of the embryo.

If six months after giving up contraception, pregnancy does not occur, then you should contact the gynecologist of the AltraVita clinic to find out the cause of reproductive dysfunction.

It is believed that after consumption oral contraceptives increase the chances of conception. Some women are prescribed OK just for this purpose. However, both the administration of the drug and its consequences have certain features.

Oral contraceptives

The action of hormonal drugs with a contraceptive effect is based on the principle of suppressing the work of the ovaries. The processes of the reproductive system are inhibited, which makes conception impossible. does not occur during the use of tablets. Instead of menstruation, a woman regularly has menstrual-like discharge.

The main function of oral contraceptives is protection against unwanted pregnancy. But in some situations, doctors prescribe OK for the treatment of ovarian dysfunction. Contraceptives contain two types of hormones - gestagens and estrogens. In a certain dosage, this tandem suppresses, prevents the corpus luteum from forming and prevents the entry into the uterine cavity.

ON A NOTE! Contrary to popular belief, oral contraceptives do not contribute to weight gain.

Can you get pregnant after taking birth control?

While taking contraceptives, a woman cannot become pregnant. Percent protection against unwanted pregnancy 99.9%, but after stopping the use of birth control pills, the ovaries begin to function in an intensive mode. Therefore, the chance of getting pregnant is very high.

The method of using contraceptives is called rebound effect. It is used in the presence of various diseases that prevent a woman from becoming pregnant. Indications for taking contraceptives include the following:

• Surgical interventions in case of unsuccessful pregnancy.
• Ovarian dysfunction.
• Mastopathy.
• Endometriosis.
• Skin diseases.
• Ovarian cysts.

REFERENCE! Birth control pills are prescribed depending on the woman's hormone levels. Before you start using it is very important to pass the necessary tests.

How quickly after canceling OK can I plan to conceive?


The effect of the drug present only in the cycle in which it is received. The constituent components of the tablets do not affect further pregnancy.

Conception is possible as early as the next month after the cancellation of OK, but experts recommend a small examination that will indicate the level of hormones, condition and follicular growth.

After the abolition of hormone-containing drugs for some time, the cycle may return to normal. This is manifested in its unstable duration. The restoration of the body is carried out in within three months. But most often, women become pregnant already in the first cycle after stopping the intake.

What problems can you face?

Almost any medical device has contraindications and side effects. Oral contraceptives have a pronounced effect. That is why they must be taken with extreme caution. After the abolition of contraceptives, some complications may occur. These include:

• Violation of carbohydrate and lipid metabolism.
• Diseases of the cardiovascular system.
• Infertility (subject to prolonged use of OK).
• Violation of the cycle of menstruation.

For the purpose of pregnancy, most often, the method of taking contraceptives for three months is used. Sometimes the duration of use of the drug can reach six months. Longer use has a marked effect on processes of the reproductive system. Therefore, there is a possibility of infertility.

During application, a woman may experience the appearance side effects. If they are pronounced, then OK is chosen incorrectly. The presence of symptoms should be reported to the attending physician. The main side effects include:

• Dizziness and nausea.
• Decreased libido.
• The appearance of irritability.
• Increase in vegetation.
• Smearing secretions.
• Sensitivity of the mammary glands.

IMPORTANT! In the process of selecting contraceptives, many nuances are taken into account: the age of the patient, the experience of pregnancy and childbirth, weight, etc.

How to increase the chances of successful conception?

Some actions of a woman can bring desired pregnancy and help avoid possible complications. The main rule when taking OK is compliance with the dosage. Oral contraceptives are taken at the same time every day. When skipping a tablet, you must follow the recommendations specified in the instructions. This will help to avoid hormonal failure. The last pack of tablets must be drunk to the end.

REFERENCE! Statistical data indicate the likelihood of developing multiple pregnancies after the abolition of OK.

At the stage of recovery of the body after treatment with contraceptives, it is recommended to take complexes containing the necessary vitamins. Their compliance with the norms will favorably affect development of pregnancy.

It is forbidden to use and. during this period should be as balanced as possible. Vitamins and minerals should be supplied to the body not only as part of supplements, but also with food. In this case, they are absorbed much better.

Sometimes, to increase the likelihood of conception, doctors prescribe certain medications. medical devices. These include Cyclodinone, Time Factor and Duphaston. The listed drugs regulate the menstrual cycle and restore.

- I've been taking birth control pills for a year now. Should I take a break?
- Are you planning a pregnancy?
- No, I don’t plan for another year and a half.
"Then why are you taking a break?"
- So they say that you can’t drink for a long time! Then you will not get pregnant or you will have to be treated for a long time.

For many years I could not understand where these recommendations come from. In no manual on contraception, in any textbook, in any scientific article, I have ever seen data on the need to take a “break-rest” after any long-term use of hormonal contraceptives.

Hormonal contraception was originally conceived as a reversible method - the ability to conceive is restored quickly. However, the fear that the ovaries will “go to sleep and not wake up” is quite common.

I believe that we are confronted with a certain kind of gynecological folklore. The recommendation to "take a break" from taking COCs is passed from mouth to mouth from the older generation of gynecologists to the younger. This unwritten rule can originate in the methodological letters of the USSR Ministry of Health, issued in hundreds of thousands of copies in 1981 and 1985. In those days in the USSR, it was believed that the number of contraindications to hormonal contraception is enormous, and the side effects are so detrimental that the appointment of a COC by a Soviet doctor casts doubt on his professional competence 1 .

“In our country, it is not uncommon for a doctor to sincerely believe that taking COCs needs breaks.”
Khamoshina - Doctor of Medical Sciences, Professor of the Department of Obstetrics and Gynecology, Peoples' Friendship University of Russia.

More than 30 years have passed. Young students and young doctors of those controversial times entered a time of significant professional maturity and clinical authority. The impression of youth is the brightest. It is possible that many, while maintaining an extremely cautious attitude towards hormonal contraceptives, ignore the data of modern studies and WHO recommendations on contraception 2 .

How justified is such caution?

Every obstetrician-gynecologist in the "piggy bank" there is a whole bunch of such stories. This case was presented by Doctor of Medical Sciences, Professor M. B. Khamoshina 3 .

A young woman, who had been taking a low-dose COC for 8 months, came to the antenatal clinic for a preventive appointment. The drug was well tolerated, the chosen method of contraception was satisfied.

The patient underwent an ultrasound, according to the results of which the doctor of the highest category came to the conclusion: “You have a tiny uterus and will never have children. Are you crazy? Immediately cancel the hormonal drug, we will grow your uterus! Of course, the woman immediately stopped taking such "dangerous" pills and, as prescribed by the doctor, began to "grow the uterus" with the help of "Cyclo-Progynova". Exactly 2 months later, the uterus grew to 6 weeks of pregnancy, and the patient went for an abortion. Of course, this woman, calmly and happily taking COCs, was all right. Before visiting the doctor.

Reducing the size of the ovaries and uterus on the background of long-term COC use is a well-known phenomenon. In 2011-2014, a group of Danish scientists led by Petersen 4 convincingly showed that in women using oral contraception, ovarian volume decreases by 2 times, and the level of AMH (anti-Müllerian hormone - correlates with the number of “good” follicles in the ovaries) decreases by 19 %. However, the authors emphasize that this effect is completely reversible.

The patient may be concerned about the lack of independent menstruation after stopping the use of COCs. This is exactly the case when it is worth waiting a bit and letting the body “wake up”, but not running for treatment, simultaneously collecting the “expert” opinion of others that now everything is definitely gone and COCs have ruined your life. Independent menstruation is restored within one or two cycles.

For most women, the ability to conceive returns immediately after stopping COC use. At the dawn of my medical practice, in some forms of infertility (with ovulation disorders), the “rebound effect”, or withdrawal effect, was successfully used: the patient was recommended to take oral contraceptives for 6 months to increase the likelihood of ovulatory cycles and the onset of pregnancy. This method has one significant drawback, which seriously limits its use today: it takes a very long time compared to IVF.

Fertility restoration issues have been carefully studied in various studies - no delays in pregnancy are observed. Every fifth woman becomes pregnant already in the first cycle after discontinuation of the drug.

A woman can become pregnant immediately after stopping COC use (Fig. 1-5)

• 21.1% of women become pregnant after 1 cycle;
• 45.7% of women become pregnant after 3 cycles;
• 79.4% of women become pregnant after 12 cycles.

In women who used barrier contraception or natural family planning methods, exactly the same data were obtained on the frequency of pregnancy. The number of infertility in marriage in women taking COCs is equal to the average population.

Moreover, modern science considers it a problem that after stopping the use of COCs, women become pregnant too quickly, not having time to accumulate enough folate in the body to prevent fetal malformations and neural tube defects. Folates accumulate in the body slowly, so you should start taking them 2-3 months before conception.

An alternative may be the use of contraceptives fortified with metafollin (Jess Plus or Yarina Plus). Contraceptives "with a plus" are recommended for patients who are planning a pregnancy in the foreseeable future.

How long can I take COCs

The main complaint about fertility preservation studies is the short duration of oral contraceptive use by the participants. In different studies, this is organized differently, usually this period is 1–2–4 years. Long-term use of COCs is considered to be more than 4 years.

It is very difficult to organize such a study for women using COCs for 5-10 years. You don't often see a woman who has a regular sex life and needs constant contraception for 10 years. Life sometimes separates us from loved ones, sometimes divorces us from our husbands, sometimes reproductive plans change in favor of childbearing. It is almost impossible to concentrate at least a few hundred such patients under the supervision of research doctors.

That is why modern medicine answers the question “How long can I take COCs?” gives an evasive answer: "As much as a woman needs this type of contraception."

“But my girlfriend…”

On the Internet, you can easily find hundreds and thousands of comments about how someone foolishly took COCs, and then could not get pregnant, was treated for a long time, the ovaries fell asleep, menstruation disappeared ... Entering into a discussion in such cases is completely pointless. COCs, providing regular menstrual-like reactions, are quite capable of masking serious problems of the reproductive system.

There can be many reasons for premature ovarian failure: heredity, weight loss, stress, endocrine and autoimmune diseases, viral infections, operations on the pelvic organs, inflammatory processes. That is why a detailed conversation with the doctor, clarifying the situation and making the correct diagnosis before starting the use of COCs is so important before choosing the drug.

If interruptions for a cycle or two threatened women only with unplanned pregnancy, this discussion could not even begin. It would seem, well, what's wrong with living without pills for a couple of months a year?

Unfortunately, the resumption of COC use after a break of more than 4 weeks is associated with an increased risk of venous thromboembolism. About contraceptives and thrombosis we'll talk to you next time.

1. Radzinsky V. E., Khamoshina M. B. Factology of “sincere delusions”. The attitude of Russian doctors to hormonal contraception / V. E. Radzinsky, M. B. Khamoshina // Status Praesens. 2011. - No. 3. - S. 16–19.
2. http://www.who.int/reproductivehealth/publications/family_planning/MEC-5/en/
3. Based on the materials of the All-Russian scientific and practical seminar "The reproductive potential of Russia: versions and controversies", Sochi, September 3, 2011. A transcript of the full audio recording of the brainstorming session is available at www.praesens.ru.
4. Peterson K. B. Ovarian reserve assessment in users of oral contraception seeking fertility advice on their reproductive lifespan // Human Reproduction, 2015. Vol. 30. No. 10. P. 2364–2375.
5. Data are presented as point estimates (solid line) with upper and lower 95% CIs (dashed line) and refer to women who definitely discontinued COCs due to pregnancy planning (n = 2064). Cronin M. et al. Rate of pregnancy after using drospirenone and other progestin-containing oral contraceptives. Obstetrics & Gynecology, 2009. Vol. 114(3). P. 616–22.

Oksana Bogdashevskaya

Photo istockphoto.com

Can taking antibiotics in the preparatory period before conception harm the unborn baby? About the features of antibiotic therapy and its effect on the body of future parents later in the article.

The prescription of antibiotics can be due to multiple reasons. Antibacterial therapy is used both for acute respiratory diseases and for sexually transmitted venereal diseases. In what case is it advisable to take a break of several months before conceiving a child, and why can the accumulation of active components in the blood harm the unborn baby?

Diseases that are of an infectious nature, bacterial etiology, require treatment with antibacterial drugs. Without the use of special antibiotics, a complication in the form of chronic diseases can develop. Often, untimely antibiotic therapy provokes complications in the form of blood poisoning against the background of suppuration and necrosis of the tissues of the affected organ.

The Nobel Prize in Medicine in the 50th year of the last century was awarded to Fleming, Chain and Flory for their achievements in science, in particular for the invention of penicillin. Such an invention made it possible to initially reduce the epidemics of plague, cholera, and then completely reduce them to zero.

Depending on the type of disease, a broad-spectrum or narrow-spectrum antibiotic is used. For example, a penicillin-based antibiotic is suitable for the treatment of ENT infections, while tetracycline, benzylpenicillin, or cephalosporin-based funds will be required to eliminate foci of genital tract infection. The main thing when choosing an effective antibiotic is the sensitivity of a pathogenic microorganism to it.

Men

Depending on the classification of the previously used antibiotic, its effect and elimination process is different. However, along with the neutralization of pathogenic microorganisms, the antibiotic also kills beneficial cells. It will take a month of rehabilitation to restore liver function. Therapy also negatively affects the reproductive function of men:

• autoimmune processes that were triggered by taking the amoxicillin group provoke a decrease in sperm activity;
• the destruction of sperm molecules (DNA) occurs while taking doxycycline, which is prescribed for venereal, genitourinary infections;
• blocking the work of the neuromuscular system and deterioration in the quality of sperm occurs after streptomycin groups;
• a decrease in the number of germ cells occurs after josamycin;
• bicillin is excreted from the body for 30-40 days. During this time, the quality of sperm is low, the number of active sperm is insufficient to fertilize the egg.

The process of sperm production in the same volume occurs against the background of a stable hormonal background in 1-2 months. If there are changes in the hormonal system, then the recovery process takes longer.

Women

The effect of any drugs on the reproductive system of women has been proven, antibacterial tablets are no exception. In addition to the fact that the body needs to recover from a course of antibiotics, the following negative factors are observed:

• suppression of ovulation;
• decreased production of the sex gonads;
• unstable maturation of the corpus luteum and ovulation processes, in particular, the growth of the endometrium;
• failure of the menstrual cycle, less often - amenorrhea;
• vaginal dysbacteriosis, thrush;
• urethritis, cystitis.

Pregnancy planning

The main secret of a successful pregnancy without complications is a strong immune system. Therefore, before conception, it is necessary not only to prepare mentally, but also to restore strength, strengthen immunity. After taking antibiotic therapy, the immune system is weakened, a long-term restoration of the intestinal microflora will be required, including.

When can you get pregnant

It is best to plan conception no earlier than 2-3 months after taking antibacterial drugs. During this time, the body restores its protective functions, there is a stabilization of the menstrual cycle in women and an increase in active sperm in men.

What are dangerous

The danger of such drugs, regardless of the form used (intravenously, intramuscularly or orally), contributes to the accumulation of toxic components in muscle mass, in blood cells and in internal organs. The formation of germ cells in men and women will be carried out, but their quality does not allow in some cases to conceive a healthy child. Sometimes, against the background of an antibiotic, deafness, heart, liver, and kidney defects are observed in a child.

Danger during conception

Some situations cannot be predicted in advance. Sometimes an unplanned pregnancy occurs during or immediately after antibiotics.

In this case, it is necessary to seek advice from narrow specialists in the field of genetics, histology and gynecology. Some drugs form complications of fetal development:

• aplasia - absence of limbs or organs;
• hypoplasia - underdeveloped organs or limbs;
• changing the shape of the nose, limbs while maintaining their functions;
• the formation of fistulas, "cleft lip".

Effect on conception

To reduce the risks for the intrauterine development of the child, it is necessary to withstand a break after therapy for at least a month. If combined drugs (antifungal, anti-inflammatory) are used, then it is necessary to restore the vaginal flora, normalize the acid-base balance of the stomach and stabilize the amount of lactacids in the reproductive tract, which takes more than two months.

How long can women get pregnant

It is worth planning a conception only after all the components of the antibiotic have been removed from the body. It is also worth considering that the filtering organs - the liver, kidneys, also need a recovery process after elimination. Therefore, the best time to prepare after antibiotics before conception is 2-3 months. The exceptions are drugs based on penicillin and cephalosporins. In this case, rehabilitation takes about a month.

What should be considered when planning the conception of a child for a man

The main task of a man in the period of preparation before conception is to restore the quality of seminal fluid. Before fertilization, it is recommended to pass a spermogram for the presence of leukocytes in it. It is also worth paying attention to the amount of seminal fluid. As practice shows, after a course of antibiotics, there is a decrease in sperm volume by half. Along with a decrease in seminal fluid, the quality of sperm also decreases, the active heads of spermatozoa are insufficient (less than 20% of active spermatozoa).

Prevention of negative consequences

It is impossible to protect yourself from all negative influences from the environment, and therefore it is also impossible to predict the need for antibiotic therapy in advance. However, if pregnancy is planned, both parents should be aware of the dangers of antibacterial drugs for the fetus.

To reduce the likely negative effects on the fetus, parents should take a three-month break after treatment, paying attention to diet, lifestyle and proper nutrition. Dairy and sour-milk products, proteins and fiber contribute to the rapid recovery of the body after antibiotics.

The preparation of a married couple for the conception of a baby occurs long before the onset of fertilization. Antibacterial treatment can slightly shift pregnancy plans by 2-3 months. However, proper preparation and restoration of the body of parents will help to conceive and give birth to a healthy baby without pregnancy pathologies.

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