Delay In Return To Fertility After Discontinuation Of Using Depo-Provera And Associated Factors Among Currently Pregnant Women Attending Antenatal Care In Public Health Facilities In Gindeberet District, West Shoa Zone, Oromia, Ethiopia, 2021

Abstract

Background: One of the of methods to control fertility is use of injectable Depo-Provera which has the side effect of delaying return to fertility after discontinuation of it. Delay of fertility return after the method termination remains a major concern for women who use it. This fear poses a negative impact on utilization and continuation of Depo-Provera in developing nations including Ethiopia. Therefore, determining the median delay of fertility return after discontinuation of Depo-Provera and identifying the associating factors are important for developing solutions to the issues of clients and health care providers Objective: To assess delay in fertility return after discontinuation Depo-Provera and associated factors among pregnant women attending ANC in public health facilities in Gindeberet district, west shoa zone, Oromia, Ethiopia ,2021 Methods: Facility based cross sectional study was conducted on 415 pregnant women attending Antenatal care in Public Health Facilities in Gindeberet district from August 10-October 10/2021.Consecutive sampling technique was used. pretested structured Interviewer-administered questionnaire was used to collect data.Data we r e entered into Epi info version 7 and then exported to SPSS version 25 for cleaning ,analysis and summarized using descriptive statistics of Frequencies and median. Bivariate and multivariable logistic regression was applied to estimate the crude and adjusted odds ratios with 95% CI to determine the presence and strength of association and P- value < 0.05 as cut off point Result: The median delay of fertility return in this study was found to be 10 months from date of Depo-Provera discontinuation. The magnitude of fertility delay in this study was 45.5%[95%CI=38.4.4%,52.6%].Multivariable analysis showed that being lower income ≤2500 ETB [AOR:0.09 (0.042,0.21)],Age group from 15-24years [AOR:0.04 (0.006, 0.23)],Age group from 25-29years [AOR:0.15(0.04,0.55)] and Age group from 30- 34yearsAOR:[0.23(0.083,0.66)],Age at first sex 19-23years [AOR:0.4(0.17,0.93)],Being sexually active1day/week[AOR:5.5(1.4,20.8)] sexually active 2-3days/week [AOR:4.2 (1.7,14.9)] these variables had significant association with delay in return to fertility after discontinuation of using Depo-Provera. No direct relation was found between the number of injections and the time required for the return of fertility for null gravid and gravid women. Conclusion and recommendation: After discontinuation of Depo-Provera there is significant delay in return to fertility. Therefore, Women should be counseled that there is a potential for delay in return to fertility following discontinuation of the method. Being older age, being higher income, infrequent sexual intercourse and delayed age at first sex were predictors of fertility delay after discontinuation of Depo-Prov