Ovarian contraceptives have been used for close to forty years and are used extensively for contraception and other treatments. In recent times the anti mullerian hormone and the antral follicle count seem to be the best parameters to detect age related egg depletion rather than FSH. With a significant number of women being on the oral contraceptive pill the question that is often asked is whether the AMH and the antral follicle count are reduced.
In one of the largest studies done in Copenhagen by Dr Ben Pentzen, demonstrated that there was a significant negative impact on the ovarian reserve parameters on women taking the oral contraceptive pill. The AMH concentrations were about 30% lower in those women who took the pill. Although some studies have not shown a significant change, there are studies that do show that the pill does suppress the ovarian reserve markers.
The normal egg growth takes about three months passing through the extremely small follicle to become what we call antral follicle. It is only when they become antral follicles that these follicles become responsive to the hormone FSH. The pill suppresses FSH and, thus, its effect tends to be on the slightly larger follicles in the ovaries. Although, pill given for more than three to six months would show a lower AMH and a lower antral follicle count of the ovary, we known that shorter courses of the pill or any hormones does not have any impact on the ovarian reserve. There is also reassurance that the impact of the pill is temporary and once the pill is stopped the AMH as well as the antral follicle count are more likely to come back to normal. Thus, on women on long term pill this AMH concentrations and antral follicle count may not retain their value as good predictors of ovarian reserve.