Ovarian Reserve Testing in Long-Term Hormonal Contraceptive Users - Proceed with Caution

Hormonal contraceptives (HCs) are commonly used by reproductive-age women. Long-term HC can transiently suppress ovarian reserve markers such as anti-Müllerian hormone and antral follicle count across routes and preparations. Suppression can occur within weeks and, in some women, may persist for several months after cessation, resulting in false positive diagnoses of diminished ovarian reserve or primary ovarian insufficiency. In this Brief Communications piece, we highlight the challenges of accurately assessing ovarian reserve in long-term HC users and provide strategies to avoid erroneous diagnoses of diminished ovarian reserve and primary ovarian insufficiency, thereby mitigating unnecessary patient anxiety and financial cost.