Ovarian function during hormonal contraception assessed by endocrine and sonographic markers: a systematic review

Abstract

This systematic review focuses on the literature evidence for residual ovarian function during treatment with hormonal contraceptives. We reviewed all papers which assessed residual ovarian activity during hormonal contraceptive use, using endocrine markers such as serum anti-Müllerian hormone (AMH) concentrations, FSH, LH, oestradiol, progesterone and sonographic markers such as antral follicle count (AFC), ovarian volume and vascular indices. We considered every type (oestroprogestin or only progestin) and dosage of hormonal contraceptive and every mode of administration (oral, vaginal ring, implant, transdermal patch). We performed an electronic database search for papers published from 1 January 1990 until 30 November 2015 using PubMed and MEDLINE. We pre-selected 113 studies and judged 48 studies suitable for the review. Most studies showed that follicular development continues during treatment with hormonal contraceptives, and that during treatment there is a reduction in serum concentrations of FSH, LH and oestradiol, and also a reduction in endometrial thickness, ovarian volume and the number and size of antral follicles. The ovarian reserve parameters, namely AFC and ovarian volume, are lower among users than among non-users of hormonal contraception; regarding the effect of hormonal contraception on AMH, there are still controversies in the literature.

The influence of lifestyle, diet, and reproductive history on age at natural menopause in Spain: Analysis from the EPIC‐Spain sub‐cohort

“…Use of OC alters hormone levels, and this further depends on the type, dosage, and mode of administration of OC. It has been observed by others that FSH, LH, and estradiol serum concentration levels decrease during OC use (D'Arpe et al, ). Inconsistent results were reported in relation to anti‐Mullerian hormone (AMH) which is used as an ovarian aging marker and an indicator of a woman's ovarian reserve.…”

“…Inconsistent results were reported in relation to anti‐Mullerian hormone (AMH) which is used as an ovarian aging marker and an indicator of a woman's ovarian reserve. While some studies observed that OC use did not influence AMH concentrations, other studies reported lower levels of AMH in OC users than in non‐users (D'Arpe et al, ).…”

Outcomes of fertility preservation in women with endometriosis: comparison of progestin-primed ovarian stimulation versus antagonist protocols

“…Second, during the initial evaluation most of the patients were on hormonal treatment (80% were taking oral progestin). The effect of hormonal treatment on AMH level remains a matter of debate [29], but few studies suggest that progestin drugs tend to decrease AMH levels [30]. Third, we chose the number of retrieved and vitrified oocytes as outcome measures.…”

Serum reproductive hormone levels and ultrasound findings in female offspring after intracytoplasmic sperm injection: first results

“…All descriptive and analytic results are stratified according to the use of hormonal contraceptives by the participants. Serum concentrations of FSH, LH, DHEAS, and E 2 in hormonal contraceptive users are reported for information only, given their suppression during hormonal contraceptive treatment (10).…”