Duration, recency, and type of hormonal contraceptive use and antimüllerian hormone levels

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Authors:

Lia A. Bernardi, M.D., Marissa Steinberg Weiss, M.D., Anne Waldo, M.S., Quaker Harmon, M.D., Ph.D., Mercedes R. Carnethon, Ph.D., Donna D. Baird, Ph.D., Lauren A. Wise, Sc.D., Erica E. Marsh, M.D. 

Abstract:

Objective

To assess whether the duration, recency, or type of hormonal contraceptive used is associated with antimüllerian hormone (AMH) levels, given that the existing literature regarding the association between hormonal contraceptive use and AMH levels is inconsistent.


Design

Cross-sectional study.


Setting

Baseline data from the Study of the Environment, Lifestyle and Fibroids Study, a 5-year longitudinal study of African American women.


Patient(s)

The patients were 1,643 African American women aged 23–35 years at the time of blood drawing (2010–2012).


Intervention(s)

None.


Main Outcome Measure(s)

Serum AMH level was measured by an ultrasensitive enzyme-linked immunosorbent assay. Linear regression models were used to estimate percent differences in mean AMH levels and 95% confidence intervals (CIs) according to use of hormonal contraceptives, with adjustment for potential confounders.


Result(s)

In multivariable-adjusted analyses, current users of hormonal contraceptives had 25.2% lower mean AMH levels than non-users of hormonal contraceptives (95% CI: −35.3%, −13.6%). There was little difference in AMH levels between former users and non-users of hormonal contraceptives (−4.4%; 95% CI: −16.3%, 9.0%). AMH levels were not appreciably associated with cumulative duration of use among former users or time since last use among non-current users. Current users of combined oral contraceptives (–24.0%; 95% CI: −36.6%, −8.9%), vaginal ring (−64.8%; 95% CI: −75.4%, −49.6%), and depot medroxyprogesterone acetate (−26.7%; 95% CI: −41.0%, −8.9%) had lower mean AMH levels than non-users.


Conclusion(s)

The present data suggest that AMH levels are significantly lower among current users of most forms of hormonal contraceptives, but that the suppressive effect of hormonal contraceptives on AMH levels is reversible.

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. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.