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J Clin Endocrinol Metab. 2011 Aug;96(8):2532-9. doi: 10.1210/jc.2010-2776. Epub 2011 May 25.

Anti-mullerian hormone predicts menopause: a long-term follow-up study in normoovulatory women.

Author information

1
Department of Reproductive Medicine and Gynecology, Division of Woman and Baby, University Medical Center Utrecht, GA Utrecht, The Netherlands. S.L.Broer@umcutrecht.nl

Abstract

CONTEXT:

It has been hypothesized that a fixed interval exists between age at natural sterility and age at menopause. Both events show considerable individual variability, with a range of 20 yr. Correct prediction of age at menopause could open avenues of individualized prevention of age-related infertility and other menopause-related conditions, like cardiovascular disease and breast carcinoma.

OBJECTIVE:

The aim of this study was to explore the ability of ovarian reserve tests to predict age at menopause.

DESIGN AND SETTING:

We conducted a long-term follow-up study at an academic hospital.

PARTICIPANTS:

A total of 257 normoovulatory women (age, 21-46 yr) were derived from three cohorts with highly comparable selection criteria.

INTERVENTIONS:

Anti-Müllerian hormone (AMH), antral follicle count, and FSH were assessed at time 1 (T1). At time 2 (T2), approximately 11 yr later, cycle status (strictly regular, menopausal transition, or postmenopause) and age at menopause were inventoried.

MAIN OUTCOME MEASURES:

Accuracy of the ovarian reserve tests in predicting time to menopause was assessed by Cox regression, and a nomogram was constructed for the relationship between age-specific AMH concentrations at T1 and age at menopause.

RESULTS:

A total of 48 (19%) women had reached postmenopause at T2. Age, AMH, and antral follicle count at T1 were significantly related with time to menopause (P < 0.001) and showed a good percentage of correct predictions (C-statistic, 0.87, 0.86, and 0.84, respectively). After adjusting for age, only AMH added to this prediction (C-statistic, 0.90). From the constructed nomogram, it appeared that the normal distribution of age at menopause will shift considerably, depending on the individual age-specific AMH level.

CONCLUSIONS:

AMH is highly predictive for timing of menopause. Using age and AMH, the age range in which menopause will subsequently occur can be individually calculated.

PMID:
21613357
DOI:
10.1210/jc.2010-2776
[Indexed for MEDLINE]

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