Fertility Beliefs and Menstrual Experiences Among Women Entering Opioid Use Disorder Treatment

OBJECTIVES: Although many people with OUD may believe they are infertile due to chronic opioid use contributing to menstrual irregularities, minimal data exists on how opioid cessation and OUD treatment may impact fertility. We examine fertility perceptions and menstrual cycle characteristics of treatment-seeking women with OUD. METHODS: Data came from the Survey of Key Informants' Patients (SKIP) Program, a US-based opioid surveillance study of individuals newly entering OUD treatment. The SKIP Program recruits adults newly entering treatment for OUD to complete anonymous, self-report surveys. Respondents who identified as female or non-binary from 49 SUD treatment programs in 25 states were asked questions about their perceptions of fertility and menstrual cycle characteristics from January to March 2024. Analyses were restricted to women 18-49 years old with no history of hysterectomy. RESULTS: Of 637 respondents, 179 met criteria for analysis. The average age was 34.8 years (SD 7.0), 15.1% identified as Black, 10.6% Native American/Alaskan Native, and 58.7% White. The most common OUD treatment was buprenorphine (47.5%). Of respondents, 51.5% (85/165) did not believe they could become pregnant. Half (57.0%, 102/179) reported either irregular or no menstrual cycles in the year prior. Respondents who believed they could become pregnant were younger (32.0 vs. 37.1 y, P<0.0001) than those who believed they were infertile. CONCLUSIONS: Menstrual irregularities and perceptions of infertility were high among a nationally representative sample of treatment-seeking women with OUD, highlighting the need for patient-provider discussions about these topics in the context of OUD treatment.