First, a quick refresher on how AMH gives an estimate of your egg count. When we want to measure egg count, we can’t actually count the eggs in your ovaries (they’re too small). But we know that each egg sits inside a follicle and each one of those follicles produces a hormone called AMH. So when we measure the amount of AMH in the blood this tells us how many follicles there are - and since each follicle holds an egg, we get a good idea of how many eggs there are too. AMH testing of egg count is used in fertility clinics worldwide. 

One question you might have is whether you can test AMH while you are using contraception. The good news is that it's medically accepted to test your AMH while on all forms of contraception - and it’s obviously also really convenient! 

But it’s important to know that in some people AMH might be artificially lowered by certain types of contraceptives called hormonal contraceptives. If you’re one of those people whose AMH levels are affected by your contraceptive (it's not everyone), the key thing to remember is it's just the hormone level in your blood that's been lowered - you haven’t actually lost any eggs. It’s also only temporary and once you stop using your contraceptive, your AMH levels will bounce back to where they would usually be. 

The thing that’s difficult to predict is who might be affected and just how big that effect might be. In some people the effect is zero, in some it’s just a little and in others it can lower AMH levels by a lot. So we’ve put together a list of Q&A’s to answer the most important things you need to know about testing your AMH on contraception.

Do all types of contraceptives have the potential to artificially lower AMH levels?

No, only hormonal contraceptives. The following contraceptive types are hormonal:

The below types of contraceptives don’t contain hormones and have no effect on your AMH:

Does hormonal contraception always affect AMH levels and by how much?

No, hormonal contraception doesn’t always affect AMH levels. For some it has no impact and for others, it might slightly lower AMH levels without changing the result range (e.g. an in-range is still an in-range). However, in certain people, it can lower AMH enough to move the result to a different range (e.g. from in-range to low). Remember, this doesn’t mean you’ve lost any eggs; it's just the amount of AMH in your blood that's been temporarily lowered.

If my hormonal contraceptive could possibly affect my AMH, why would I test while using it?

Testing your egg count tells you if you are at risk of running out of eggs early. It’s important reproductive health information because if this is you, knowing sooner puts you in the best position to keep your fertility options open. 

But it’s not always convenient to stop using your hormonal contraceptive. So, even though hormonal contraception can artificially lower AMH in some people, it's still useful to test while using them. Here’s why:

1. Your result comes back “in-range” or higher which means:

Either way, you’re not at risk of running out of eggs early.

2. Your result comes back “low” which means:

You’ll need to stop your contraceptive and retest to determine which one it is.

So you can see how testing your AMH on your hormonal contraception can confirm you’re not at risk of running out of eggs early without any inconvenience. But, you’ll need to keep in mind that if your result does come back low, further investigation might be needed.

I received a “low” result while testing on a hormonal contraceptive. How do I find out if my AMH was temporarily lowered?

The only way of confirming if your result is in fact “low” is by stopping using your hormonal contraceptive for at least 3 months and then retesting your AMH. This is an important decision that needs to be made with your health practitioner so that you can discuss your individual circumstances with them as well as the benefits of doing this. And remember, you will need to use a reliable form of alternate contraception if you don’t want to become pregnant.

I received a “low” result while on hormonal contraception - if I retest after stopping use will my AMH come back higher?

The answer to this could be yes or no. Your hormonal contraceptive may not have affected your AMH levels at all and your low result may be accurate. Your hormonal contraceptive could also have only affected your AMH level so slightly that although the number does come back a little higher, you’re still in the “low” range. Finally, it’s also possible that your AMH levels were significantly affected by your hormonal contraceptive and your result doesn’t come back low again. 

I’ve received a low result and I don’t want to come off my hormonal contraception - do I have to retest?

No. This is absolutely your decision. Your egg count is an important consideration in your fertility picture but it does not predict your ability to become pregnant. You and your healthcare practitioner should weigh up the importance of understanding your egg count in the context of your individual circumstances and family planning goals.

My AMH came back in-range/high while on hormonal contraception - do I need to retest?

No. WHEN’s Egg Count Check is a screening tool to identify if you are at risk of running out of eggs early. If your AMH result is in-range or high while on hormonal contraception, you don’t currently have a low egg count. Your result might be higher if you retested after stopping hormonal contraception, but unless you have a specific reason to find this out, there’s no need to retest.

I’ve stopped my hormonal contraception but it hasn’t been 3 months yet - can I test my AMH?

You need to wait 3 months so you can be sure that your AMH result hasn’t been affected by your hormonal contraception.

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DISCLAIMER

If you have any questions or concerns about your health, it is important to discuss them with your healthcare provider. It is important to note that our articles are not intended to replace professional medical advice, diagnosis, or treatment.