The Pill is one of the most popular forms of contraception in Australia and is taken by an estimated 100 million women worldwide. Nonetheless, one question many women want to know is, will taking the pill impact my long-term fertility?
A Danish study reported at the world’s largest fertility conference, the European Society of Human Reproduction and Endocrinology 2014 Annual Meeting this week indicated the Oral Contraceptive Pill has a noticeable suppressive effect on key predictive markers used to assess “ovarian reserve” with outcomes significantly lower in Pill users compared to non-users.
Whilst the headline above suggests women on the pill have lowered ovarian reserve, it should be highlighted that this study reaffirms what we already know about the oral contraceptive pill in that women currently taking the pill will experience suppressed ovarian function, and that normal ovarian function should resume once the pill has been ceased and her future fertility should not be impacted. It also highlights the importance of a thorough understanding of the issues for the doctor ordering the test.
How do you assess ovarian reserve?
Ovarian reserve refers to the number of viable eggs that are left in a woman’s ovaries. It is most accurately assessed by a blood test measuring the level of Anti-Mullerian Hormone, or AMH, a hormone secreted by cells in the developing egg sacs, in combination with an ultrasound, that counts the number of early antral follicles (AFC) in the ovary.
What were the study findings?
The study, which included 833 women (aged 19-46 years) from August 2011 – April 2014, compared measurements of AMH, AFC and ovarian volume in users and non-users of the Pill. It was noted that measurements of AMH and AFC were 19% and 16% lower in Pill users compared to those not taking the Pill.
What if I want to conceive?
The results of this study should not alarm women who have taken or are currently taking the contraceptive pill and hope to conceive either now or in the future. Evidence would suggest that the effects of the Pill on ovarian reserve are only temporary while the woman is actually taking the pill, and it does not change the ovaries in any permanent way. Once the pill is ceased, ovarian function is expected to resume, and a woman’s future fertility status should not be impacted.
What is the importance of this study?
This study highlights that the measurements of AMH and AFC in the assessment of reproductive status must be modified in those taking the pill, in light of the fact that women taking the pill will have lowered ovarian reserve due to the pill’s effect on suppressing ovarian function.
Women who are currently taking the pill should therefore consider delaying having their AMH levels tested until at least three months after they have ceased taking the pill to obtain an accurate indication of their fertility status.
Assessing Your Own Fertility
If you are concerned about your fertility and have been trying to conceive for six months or more and are over the age of 36, you may wish to consider speaking with a Fertility Specialist.
This data was presented by Dr Kathrine Birch Petersen from the Copenhagen University Hospital in Denmark ‘on Wednesday 2 July 2014 at the ESHRE annual meeting in Munich. Abstract 0-203, Wednesday 2 July 10.15 CET – Ovarian reserve assessment in users of oral contraception seeking fertility advice on their reproductive time span.