6. Family Planning: The integration of infertility management into Family Planning/ Reproductive Health services mutually strengthens these services.
“Family planning must also mean planning for families” (Mahmoud Fathalla, former president of FIGO).
Contraceptive methods reduce the risk of subsequent infertility by preventing unwanted pregnancies and the ensuing risks associated with unsafe abortion. Additionally, irrespective of their contraceptive efficiency, barrier methods reduce the risk of sexually transmitted diseases and pelvic inflammatory disease, which may cause tubal factor and male factor infertility. Therefore, universal access to quality contraception services will reduce the prevalence of infertility and thus form part of an infertility prevention strategy.
The fear of infertility is, however, an important barrier to the use of contraception in many developing countries. Studies from sub-Saharan Africa describe that many women and men believe that the use of contraception can cause permanent sterility (Dyer et al, 2002; Koster, 2010, 1999; Upton and Dolan, 2011). At the same time, existing family planning services usually promote pregnancy prevention but have little to offer those desiring fertility. The fear of contraception-induced infertility combined with the lack of infertility management undermines the use of contraception.
By incorporating the planning for families into existing family planning and reproductive health services, relevant advances in reproductive health can be achieved. Infertility management will include counseling patients that contraception does not cause infertility but rather prevents it, while offering infertility treatment or referring for such treatment. The same services will continue to promote contraception, sexual health, and planned parenthood. This integrated approach is likely to improve patient satisfaction, contraceptive use and overall reproductive health.