Pregnancies diagnosed during Depo-Provera use

We conducted a review of contraceptive failures among women using Depo-Provera (depot medroxyprogesterone acetate), using reports to the Insurance Division of Planned Parenthood Federation of America, Inc. Cases were included if the Depo-Provera had been given at a Planned Parenthood center and pregnancy had either been diagnosed by, or reported to, a Planned Parenthood center. There were 402 reports of pregnancy from 1994 through 1998. The crude rate of reported pregnancies was 0.42 pregnancies per 1000 women using Depo-Provera each year. Pregnancy was diagnosed after the first trimester in 46% of women. Seventy-seven women (19.1%) received additional Depo-Provera injections while pregnant. Of the women whose date of conception could be estimated, 113 of 258 (45%) became pregnant after the injection. There was no observed increase in ectopic pregnancy rate, and no fetal anomalies were reported. Although pregnancy during Depo-Provera use is rare, it does occur. These pregnancies are frequently unrecognized until beyond first trimester.