In the many years since contraception was first ventured on as a topic for discussion at medical meetings, I have had occasion to call attention to the fact that this practice would inevitably be resorted to by some—perhaps by many—married couples who were actually or potentially infertile. This observation was based on early work with uterotubal insufflation, in which several women who had used contraceptive methods proved to have a pathologic barrier to conception in the tubes which rendered preventive measures actually unnecessary. The barrier might well have been present at the time of, or shortly after, marriage and was incidentally masked by the contraceptive practice.
Many similar cases have since come under personal observation in a large number of women who have sought relief for primary sterility. But this difficulty has not been confined to childless women. There were an increasing number of women who, having employed contraception for
RUBIN IC, ZAKIN D. CONTRACEPTION MASKING STERILITY AND INFERTILITYTubal and Seminal Factors in 1,000 Cases. JAMA. 1946;132(17):1047–1053. doi:10.1001/jama.1946.02870520001001