Antimüllerian hormone levels decrease in women using combined contraception independently of administration route

In young healthy, normal weight women, continuous use of combined contraception leads to a decrease in serum AMH levels independently of administration route.

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Sanna Kallio, M.D., Johanna Puurunen, M.D., Aimo Ruokonen, M.D., Ph.D., Tommi Vaskivuo, M.D., Ph.D., Terhi Piltonen, M.D., Ph.D., Juha S. Tapanainen, M.D., Ph.D.

Volume 99, Issue 5, Pages 1305-1310, April 2013



To compare the effects of continuous use of oral, transdermal and vaginal combined contraceptives (CCs) on the pituitary-ovarian axis and inhibition of follicular development.


Spin-off study of a prospective, randomized trial.


University clinic.


Forty-two of 54 healthy women completed the study.


Treatment with combined oral contraceptives (ethinyl estradiol [EE] and desogestrel), transdermal patches (EE and norelgestromin) or vaginal rings (EE and etonogestrel) for 9 weeks continuously. Blood sampling was performed before and at 5 and 9 weeks of treatment.

Main Outcome Measures:

Changes in serum hormone levels induced by CCs.


Serum AMH, FSH, inhibin B, LH and estradiol (E2) levels had decreased significantly in all study groups after 9 weeks of treatment. Significant declines were already detected after 5 weeks’ use of CCs as regards all hormone levels apart from those of serum AMH, where the decrease between baseline and 5 weeks was only moderate. Between groups, serum levels of AMH, inhibin B, LH, and E2 were comparable at baseline and after 5 and 9 weeks of treatment.


The decrease of serum AMH levels during the use of all CCs indicates that folliculogenesis is arrested independently of administration route.

Trial Registration Number:


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Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders.