Anti-Müllerian hormone levels among contraceptive users
Anti-Müllerian Hormone has become the clinical biomarker-based standard to assess ovarian reserve. As Anti-Müllerian hormone testing becomes more common, more individuals are seeking to interpret values obtained while using contraceptives.

This research was aimed to study the association between different forms of contraceptives and anti-Müllerian levels in women of reproductive age. A cross-sectional study of 27,125 U.S.-based women aged 20-46 accessing reproductive hormone results through Modern Fertility who provided informed consent to participate in research.

Anti-Müllerian hormone levels were collected via dried blood spot card or through venipuncture. Multiple linear regressions were run to compare anti-Müllerian hormone levels in women using contraceptives to 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. They also analyzed whether the duration of contraceptive use predicted anti-Müllerian hormone levels in users of the hormonal intrauterine device and combined oral contraceptive pill has given the size of these contraceptive groups.

- Mean anti-Müllerian hormone levels were statistically significantly lower in women using the combined oral contraceptive pill, ring, hormonal intrauterine device, implant, or progestin-only pill relative to women not on any contraceptive when controlling for covariates.

- Anti-Müllerian hormone levels were not significantly different when comparing women not using any contraceptives to those using the copper intrauterine device.

- Associations between contraceptive use and anti-Müllerian hormone levels did not differ based on self-reported polycystic ovary syndrome diagnosis.

- Duration of hormonal intrauterine device use, but not of combined oral contraceptive pill use, was slightly positively associated with anti-Müllerian hormone levels, though this small magnitude effect is likely not clinically meaningful.

Conclusively, current hormonal contraceptive use is associated with a lower mean anti-Müllerian hormone level compared to women who are not on contraceptives, with variability in the percent difference across contraceptive methods.

American Journal of Obstetrics & Gynecology
Source: https://doi.org/10.1016/j.ajog.2021.06.052
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