Assessment of Circulating Anti-Müllerian Hormone in Women Using Hormonal Contraception: A Systematic Review

Amer, Saad A.K.S.; James, Cathryn; Al-Hussaini, Tarek Khalf; Mohamed, Ahmed Aboelfadle

Abstract

Background: The status of ovarian reserve markers during hormonal contraception (HC) remains uncertain with conflicting literature data. The purpose of this study was to assess the impact of HC on circulating anti-Müllerian hormone (AMH) and other ovarian reserve markers.

Materials and Methods: A systematic review was conducted, including all cohort, cross-sectional, and randomized controlled studies assessing serum anti Müllerian hormone concentration in women using HC. Data sources included MEDLINE, EMBASE, DynaMed Plus, ScienceDirect, TRIP database, ClinicalTrials.gov, and the Cochrane Library from January 2000 to October 2018.

Results: A total of 366 studies were identified, of which 15 were eligible, including 3280 women, mostly using combined HC (CHC). Articles were divided according to duration of HC into short- (2–3 weeks), medium- (2–6 months), long- (>1 year), and varied-term studies. Two study designs were identified, including studies comparing AMH before and during/after CHC and studies comparing CHC users versus nonusers. Short- and medium-term studies (n = 284) reported no change in circulating AMH in women using cyclical CHC for one to six cycles. Apart from one study, all long- and varied-term studies (six studies, n = 1601) consistently showed a marked decline in AMH, antral follicle count, and ovarian volume. Three long-term studies (n = 1324) provided evidence of AMH recovery after discontinuation of HC.

Conclusion: Circulating AMH seems to remain unchanged in women using cyclical CHC for up to 6 months, but appears to markedly decline in long-term users with recovery after discontinuation.

Citation

Amer, S. A., James, C., Al-Hussaini, T. K., & Mohamed, A. A. (2019). Assessment of Circulating Anti-Müllerian Hormone in Women Using Hormonal Contraception: A Systematic Review. Journal of Women's Health, 29(1), 100-110. https://doi.org/10.1089/jwh.2019.7733

• Journal Article Type: Article
• Acceptance Date: Jun 11, 2019
• Online Publication Date: Jul 16, 2019
• Publication Date: Jul 16, 2019
• Deposit Date: Aug 4, 2019
• Publicly Available Date: Jul 17, 2020
• Journal: Journal of Women's Health
• Print ISSN: 1540-9996
• Electronic ISSN: 1931-843X
• Publisher: Mary Ann Liebert
• Peer Reviewed: Peer Reviewed
• Volume: 29
• Issue: 1
• Pages: 100-110
• DOI: https://doi.org/10.1089/jwh.2019.7733
• Keywords: Hormonal contraception, Anti-Mullerian hormone, Ovarian reserve, Antral follicle count and ovarian volume
• Public URL: https://nottingham-repository.worktribe.com/output/2324349
• Publisher URL: https://www.liebertpub.com/doi/10.1089/jwh.2019.7733
• Additional Information: Final publication is available from Mary Ann Liebert, Inc., publishers http://dx.doi.org/10.1089/jwh.2019.7733