This study was a descriptive-analytical case-control study aimed to investigate the association between infertility and intentional delay of childbearing and the type and duration of contraceptive use among infertile couples referring to the Al-Zahra Infertility Center of Shahrekord in 2022.
The results of the present study indicated that the most commonly used contraception method in both groups (case: 50.3%, control: 46.2%) was the whithdrawal method.
In this regard, studies have produced many conflicting findings. Two studies conducted in Iran are in line with the present study, stating that the most commonly used contraception method by the studied samples was the whithdrawal method (28, 29), while contradictory results can be seen in other studies, with condoms and IUDs rated as the most commonly used methods of contraception in some studies (30, 31). A study by Esmailizadeh and colleagues. (2012) reported that oral contraceptive pills (OCP) were the most commonly used method by fertile and infertile couples to prevent pregnancy (6).
The contradictions between these studies and the present study may be due to differences in study type and sample size; this study is a case-control study, whereas the study by Esmaeilizadeh was a descriptive epidemiology study with a large sample size. On the other hand, this study looked at all types of contraceptive methods, whereas the study by Esmaeilizadeh looked at OCP, IUD, and tubal ligation methods, which could be another reason for the difference in the results of these studies.
The study results showed no statistical association between the duration of contraceptive use (intentional delay of childbearing) and infertility.
The results of most of the studies were in line with our findings (13, 14), e.g., the duration of using various contraceptive methods in the study by Noronha and co-workers. (2022) was not related to the fertility return rate (15), and the duration of using contraceptive methods was not even related to the type of infertility, i.e. primary or secondary infertility (12). However, another study found a significant association between the duration of contraceptive use and infertility, reporting that couples using contraceptive methods for more than two years had an increased risk of infertility (11).
The contradiction between this study and our study may be due to the difference in the study type and sample size; the present study was a case-control, while the other study was cross-sectional descriptive. The difference in the type of data collection may be another cause of this contradiction because most of the data of the present study was obtained from the data recorded in the participants’ files while in the other study, the data were collected through interviews.
The present study found a significant association between the type of contraceptive method and infertility, with the control group using more condoms and pills and fewer IUDs than the case group, but there was no difference in terms of the use of injectable contraception between the groups.
The results of most of the studies on the types of contraceptives used were in conflict with the results of the present study. In the study by Esmaeilizadeh and co-authors. (2012), the use of birth control pills, IUD, and tubal ligation was significantly higher in the control group compared to the case group (6). The results from another study in Yazd showed no association between IUD use and infertility (21). The results of a study by Noronha and co-workers. (2022) also suggested that there was no difference between the use of different types of hormonal and non-hormonal contraceptives in terms of the duration of fertility return (15).
The contradictions between these studies with and present study may be due to the different type of study; while the other studies were cross-sectional and cohort, ours was a case-control study. Differences in sample sizes and sampling methods can also be the reason for contradictions.