Aim:
To evaluate the effect of hormonal contraception (HC)
on the ovarian reserve markers antral follicles count (AFC) and Anti-mullerian
hormone (AMH) and their ability to predict
IVF outcome.
Methods: Prospective cohort of 98 women aged 20-37 undergoing IVF-PGD treatment. Before the treatment cycle 41 women received HC and 57 used non-HC. Main outcome measures were ovarian reserve markers [serum AMH levels and ovarian volume and small (2-5mm) and large (6-10mm) AFC, determined during the early follicular phase], ovarian response to stimulation and embryo quality.
Results: HC users and nonusers were similar regarding women's age, the number of oocytes and embryo quality. There was no difference between HC users and non users in AMH levels and small AFC. However, mean large AFC (4.07 ± 4.9 and 5.88 ±3.2) and mean ovarian volume (3.89 ± 2.03 and 6.94 ± 3.26 ml) were significantly higher in the non HC users, P = 0.04 and P<0.0001, in HC and non HC users, respectively.
The number of oocytes significantly correlated with AMH levels and with total AFC in women taking HC (r=0.636, r=0.629 respectively, p <0.001), in comparison to nonusers in which the correlation of AMH and total AFC to the number of oocytes was less strong (r=0.265 p=0.86, r=0.464 respectively p<0.001).
Conclusion: HC did not affect the ovarian reserve markers AMH and total AFC. HC use was accompanied by a decrease in the number of follicles 5-9 mm and in ovarian volume. IVF outcomes can be predicted safely using ovarian reserve markers in women using HC. These findings are particularly important in the group of women treated with PGD to assess their prognosis and to determine the treatment protocol
