Hormonal contraceptives such as birth control pills, vaginal rings, hormonal intrauterine devices, and implants can temporarily suppress ovarian function, including the production of anti-mullerian hormone (AMH). AMH, primarily produced by small ovarian follicles, serves as a marker of ovarian reserve.
While research on this topic varies, a notable study in 2021 published in the Journal Fertility and Sterility found that women using most types of hormonal contraceptives (like the pill, Depo-Provera injection, and vaginal rings) tended to have lower AMH levels compared to those who didn't use contraceptives. This suggests these methods may temporarily affect ovarian reserve markers.
Additionally, a study from Europe observed that users of the levonorgestrel-releasing intrauterine system also had lower AMH levels compared to non-hormonal contraceptive users. While these findings don't confirm a direct cause-effect relationship, they do indicate an association between different hormonal contraceptives and decreased AMH levels.
Importantly, this effect of decreased AMH is typically reversible upon discontinuation of birth control.
Considering these insights, it's advisable to discuss the timing of AMH testing with your healthcare provider if you're currently using hormonal contraceptives and contemplating fertility assessment or planning. They can offer personalized guidance on when to temporarily discontinue contraceptives for more reliable AMH results.
In clinical practice, if your initial AMH results show strong levels, it often means there's no immediate need for further testing. However, if you've been using hormonal contraceptives long-term and find unexpectedly low AMH levels for your age, taking a break from these contraceptives and retesting after 1-2 months can offer a clearer picture of your ovarian reserve.
If you have specific concerns, consulting with a fertility doctor (reproductive endocrinologist) would provide valuable insights and reassurance about your fertility potential.
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Irene Woo, MD, FACOG is an esteemed and compassionate medical professional holding dual board certifications in Obstetrics and Gynecology, as well as Reproductive Endocrinology and Infertility. Dr. Woo’s extensive contributions to the field are well-documented, with numerous scientific and clinical articles published in reputable peer-reviewed journals such as Fertility and Sterility, and the Journal of Assisted Reproduction and Genetics. In addition to conventional IVF treatments, Dr. Woo specializes in minimal stimulation IVF, oncofertility, fertility preservation, and precision medicine. Learn more about HRC Fertility’s egg freezing practice on Freeze.
