Antimullerian hormone levels decrease in women using combined contraception independently of administration route

Objective: To compare the effects of continuous use of oral (OC), transdermal, and vaginal combined contraceptives on the pituitary-ovarian axis and inhibition of follicular development. Design: Spin-off study of a prospective, randomized trial. Setting: University clinic. Patient(s): Forty-two of 54 healthy women completed the study. Intervention(s): Treatment with combined OCs (ethinyl E-2 [EE] and desogestrel), transdermal patches (EE and norelgestromin), or vaginal rings (EE and etonogestrel) for 9 weeks continuously. Blood sampling was performed before and at 5 and 9 weeks of treatment. Main Outcome Measure(s): Changes in serum hormone levels induced by combined contraceptives. Result(s): Serum antimullerian hormone (AMH), FSH, inhibin B, LH, and E-2 levels had decreased significantly in all study groups after 9 weeks of treatment. Significant declines were already detected after 5 weeks' use of combined contraceptives with regard to all hormone levels apart from those of serum AMH, where the decrease between baseline and 5 weeks was only moderate. Between groups, serum levels of AMH, inhibin B, LH, and E-2 were comparable at baseline and after 5 and 9 weeks of treatment. Conclusion(s): The decrease of serum AMH levels during the use of all combined contraceptives indicates that folliculogenesis is arrested independently of administration route. Clinical Trial Registration Number: NCT01087879. (Fertil Steril (R) 2013; 99: 1305-10. (C) 2013 by American Society for Reproductive Medicine.)