Ovarian Reserve Dynamics in Users of Hormonal Contraceptives: A Comparative Analysis

Abstract

Background: Hormonal contraception (HC) is a cornerstone of family planning, which is preferred over non-hormonal contraceptive methods. However, the long-term impact of HC use on ovarian reserve (OR) and fertility remains an area of ongoing investigation. Objective: This study aimed to evaluate the difference in OR between hormonal contraceptive users, and non-users. Methods: A cross-sectional study was conducted with 200 women, divided equally into two groups; HC-Users: 100 women using hormonal contraception for more than one year; Non-Users: 100 women not using any contraception for at least 6 months, as a control group. OR was assessed in all participants during days (2-4) of their menstrual cycle through measurement of serum Anti-Mullerian Hormone (AMH),
Antral Follicle Count (AFC), and serum Follicle Stimulating Hormone (FSH). Results: The comparative analysis of HC-Users versus non-users revealed statistically significant differences across ovarian reserve markers. HC-Users exhibited significantly lower serum AMH levels (2.47±1.04) ng/mL compared to non-users (3.32±1.52) ng/mL, p < 0.0001. AFC was significantly reduced in HC-Users (10.21±7.41) relative to non-users (14.81±9.63), p = 0.0002. HC-Users displayed lower FSH levels (4.23±3.51) IU/L compared to non-users (6.12±1.1) IU/L, p < 0.0001. Conclusion: HC use is associated with significant reductions in OR markers; AMH, AFC, and FSH. These findings highlight an inhibitory impact of HC which may influence fertility assessments.