Family Planning

Postpartum and postabortion infections also can cause PID, which may leadto infertility. This happens when the surgical instruments used for medicalprocedures are not properly disinfected or sterilized. A woman can alsodevelop PID if an infection present in the lower reproductive tract is carriedinto the upper reproductive tract during a medical procedure.Preventing InfertilityInfertility is often preventable. Providers can:óóóCounsel clients about STI prevention (see Sexually Transmitted Infections,Including HIV, Preventing Sexually Transmitted Infections, p. 280).Encourage clients to seek treatment as soon as they think they mighthave an STI or might have been exposed.Treat or refer clients with signs and symptoms of STIs and clinical PID(see Sexually Transmitted Infections, Including HIV, Symptoms of SexuallyTransmitted Infections, p. 278). Treating these infections helps preservefertility.Avoid infection by following proper infection-prevention practices whenperforming medical procedures that pass instruments from the vaginainto the uterus, such as IUD insertion (see Infection Prevention in theClinic, p. 312).Contraceptives Do Not Cause InfertilityóóWith most contraceptive methods, there is no delay in thereturn of fertility after use is stopped. The return of fertility afterinjectable contraceptives are stopped usually takes longer than withmost other methods (see Progestin-Only Injectables, Questions 6and 7, p. 79, and Monthly Injectables, Questions 10 and 11, p. 100).In time, however, women who have used injectables are as fertile asthey were before using the method, taking aging into account.Among women with current gonorrhea or chlamydia, IUDinsertion slightly increases the risk of pelvic inflammatory diseasein the first 20 days after insertion. Still, research has not foundthat former IUD users are more likely to be infertile than otherwomen (see Copper-Bearing IUD, Question 4, p. 155).23Reproductive Health IssuesInfertility305