Anti-Müllerian hormone levels among contraceptive users: evidence from a cross-sectional cohort of 27,125 individuals

Abstract

BACKGROUND: Anti-Mü llerian hormone has become the clinical biomarker-based standard to assess ovarian reserve. As anti-Mü llerian hormone testing becomes more common, more individuals are seeking to interpret the values obtained while using contraceptives. To appropriately counsel women, a better understanding of anti-Mü llerian hormone levels in women using different contraceptives is needed. OBJECTIVE: To study the association between different forms of contraceptives and anti-Mü llerian levels in women of reproductive age. STUDY DESIGN: This is a cross-sectional study including 27,125 USbased women aged 20 to 46 years, accessing reproductive hormone results through Modern Fertility and who provided informed consent to participate in the research. Anti-Mü llerian hormone levels were collected through dried blood spot card (95.9%) or venipuncture (4.1%), and previous work has shown high correlation between hormone levels collected by these 2 methods. Multiple linear regressions were run to compare anti-Mü llerian hormone levels in women using contraceptives with women not on any contraceptive, controlling for age, age of menarche, body mass index, smoking, sample collection method, cycle day, and self-reported polycystic ovary syndrome diagnosis. We also analyzed whether duration of contraceptive use predicted anti-Mü llerian hormone levels in users of the hormonal intrauterine device and combined oral contraceptive pill, given the size of these contraceptive groups. RESULTS: Mean anti-Mü llerian hormone levels were statistically significantly lower in women using the combined oral contraceptive pill (23.

Impact of Obesity on Anti-Mullerian Hormone (AMH) Levels in Women of Reproductive Age

“…Furthermore, of the nine studies that excluded for OCP use, they did so only in the context of recent use (i.e., in the last 2 months). Studies have shown that women on OCP or other hormonal contraceptives display lower AMH levels [ 61 , 62 ] with long-term users having 30% lower AMH levels than non-users [ 63 , 64 ]. This is an important consideration in the context of this review, since hormonal contraception is known to have variable responses in obese populations [ 65 ].…”

Effects of Different Oral Contraceptives On Ovarian Reserve, Histology, and Micrornas: An Experimental Study

“…Similarly, a cross-sectional cohort study conducted with 27,125 participants showed that compared to non-users, AMH levels were lower not only in participants using oral contraceptives but also in those using vaginal rings, hormonal intrauterine devices, implants, and progestin-only contraceptive pills at variable percentages (16).…”

Effects of Levonorgestrel-Releasing Intrauterine Device Therapy on Ovarian Reserve in Menorrhagia

“…While many studies have examined the effect of LNG-IUD on uterine bleeding in the literature, very few have investigated its effects on ovarian reserve. Studies on the effects of LNG-IUD on ovarian function generally compare contraceptive methods [ 21 , 22 ].…”

“…Hariton et al [ 22 ] compared AMH among contraceptive users and women not on contraceptives and found that AMH levels were 7% lower in women with hormonal IUD, 15% lower in those taking the progestin-only pill, 22% lower in vaginal ring users, 23% lower in implant users, and 24% lower in those taking COC. They also noted that the AMH level in women using copper IUDs was not significantly different from that in women not using contraceptives.…”