AMH及基礎濾泡可用於預測更年期

AMH高低&基礎濾泡多寡可用於預測更年期之早晚，

AMH越高更年期之越晚，AMH越低更年期之越早

http://jcem.endojournals.org/content/96/8/2532.full

Anti-Müllerian Hormone Predicts Menopause: A Long-Term Follow-Up Study in Normoovulatory Women

1. S. L. Broer, 
2. M. J. C. Eijkemans, 
3. G. J. Scheffer, 
4. I. A. J. van Rooij, 
5. A. de Vet,
6. A. P. N. Themmen, 
7. J. S. E. Laven, 
8. F. H. de Jong, 
9. E. R. te Velde, 
10. B. C. Fauser and
11. F. J. M. Broekmans

-Author Affiliations

1. Department of Reproductive Medicine and Gynecology, Division of Woman and Baby (S.L.B., M.J.C.E., G.J.S., I.A.J.R., E.R.t.V., B.C.F., F.J.M.B.), and Julius Center for Health Sciences and Primary Care (M.J.C.E.), Division of Reproductive Medicine, Department of Obstetrics and Gynecology (A.d.V., J.S.E.L.), and Division of Endocrinology, Department of Internal Medicine (A.P.N.T., F.H.d.J.), University Medical Center, 3508 GA Utrecht, The Netherlands

1. Address all correspondence and requests for reprints to: S. L. Broer, M.D., Department of Reproductive Medicine and Gynecology, University Medical Center Utrecht, Room F05.126, P.O. Box 85500, 3508 GA Utrecht, The Netherlands. E-mail: S.L.Broer@umcutrecht.nl.

 

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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.