Anti-Mullerian hormone levels among contraceptive users: evidence from a cross-sectional cohort of 27,125 individuals
Anti-Mullerian hormone levels among contraceptive users: evidence from a cross-sectional cohort of 27,125 individuals
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避孕药具使用者中的抗苗勒氏激素水平：来自27,125人的横断面队列证据
DOI：
10.1016/j.ajog.2021.06.052
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发表时间：
2021-10-29
影响因子：
9.8
通讯作者：
Briggs, Sharon F.
中科院分区：
文献类型：
--
作者：
Hariton, Eduardo;Shirazi, Talia N.;Briggs, Sharon F.
背景：抗苗勒氏管激素已成为评估卵巢储备功能的临床生物标志物标准。随着抗苗勒氏管激素测试变得越来越普遍，越来越多的人正在寻求解释使用避孕药具时获得的值。为了向女性提供适当的咨询，需要更好地了解使用不同避孕药具的女性的抗苗勒氏管激素水平。目的：研究不同形式的避孕药具与育龄女性的抗苗勒管激素水平之间的关联。研究设计：这是一项横断面研究，包括 27,125 名 20 至 46 岁的美国女性，通过 Modern Fertility 获取生殖激素结果，并提供参与研究的知情同意书。抗苗勒氏管激素水平通过干血斑卡（95.9%）或静脉穿刺（4.1%）收集，先前的工作表明这两种方法收集的激素水平之间存在高度相关性。控制年龄、初潮年龄、体重指数、吸烟、样本采集方法、周期日和自我报告的多囊卵巢综合征诊断后，进行多元线性回归比较使用避孕药的女性与未使用任何避孕药的女性的抗苗勒氏管激素水平。考虑到避孕药组的规模，我们还分析了避孕药的使用时间是否可以预测激素宫内节育器和复方口服避孕药使用者的抗苗勒管激素水平。结果：使用复方口服避孕药的女性平均抗苗勒管激素水平在统计上显着降低（降低 23.68%；系数，0.76；95% 置信区间，0.72-0.81；P
BACKGROUND: Anti-Mullerian hormone has become the clinical biomarker-based standard to assess ovarian reserve. As anti-Mullerian hormone testing becomes more common, more individuals are seeking to interpret the values obtained while using contraceptives. To appropriately counsel women, a better understanding of anti-Mullerian hormone levels in women using different contraceptives is needed.OBJECTIVE: To study the association between different forms of contraceptives and anti-Mullerian levels in women of reproductive age.STUDY DESIGN: This is a cross-sectional study including 27,125 US-based women aged 20 to 46 years, accessing reproductive hormone results through Modern Fertility and who provided informed consent to participate in the research. Anti-Mullerian hormone levels were collected through dried blood spot card (95.9%) or venipuncture (4.1%), and previous work has shown high correlation between hormone levels collected by these 2 methods. Multiple linear regressions were run to compare anti-Mullerian hormone levels in women using contraceptives with women not on any contraceptive, controlling for age, age of menarche, body mass index, smoking, sample collection method, cycle day, and self-reported polycystic ovary syndrome diagnosis. We also analyzed whether duration of contraceptive use predicted anti-Mullerian hormone levels in users of the hormonal intrauterine device and combined oral contraceptive pill, given the size of these contraceptive groups.RESULTS: Mean anti-Mullerian hormone levels were statistically significantly lower in women using the combined oral contraceptive pill (23.68% lower; coefficient, 0.76; 95% confidence interval, 0.72-0.81; P