Ellen W Freeman1, Mary D Sammel, Hui Lin, Clarisa R Gracia. 1. Department of Obstetrics/Gynecology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA. freemane@mail.med.upenn.edu
Abstract
CONTEXT: Anti-mullerian hormone (AMH) has emerged as a marker of ovarian reserve and a possible surrogate measure of reproductive aging. OBJECTIVE: The aim of the study was to evaluate the predictive value of AMH levels in determining the median time to menopause for late reproductive age women and the predictive ability of AMH compared to FSH and inhibin b. DESIGN AND SETTING: A 14-yr follow-up in the Penn Ovarian Aging Study, 1996-2010, was conducted for a randomly identified population-based cohort. SUBJECTS: A total of 401 late reproductive age women participated in the study. MAIN OUTCOME MEASURE: Observed time to menopause was measured. RESULTS: All participants were premenopausal, with a mean (SD) age of 41.47 (3.52) yr and a median AMH level of 0.68 ng/ml at baseline. AMH strongly predicted time to menopause; age further improved predictions. Among women with a baseline AMH level below 0.20 ng/ml, the median time to menopause was 5.99 yr [95% confidence interval (CI), 4.20-6.33] in the 45- to 48-yr age group and 9.94 yr (95% CI, 3.31-12.73) in the 35- to 39-yr age group. With higher baseline AMH levels above 1.50 ng/ml, the median time to menopause was 6.23 yr in the oldest age group and more than 13.01 yr in the youngest age group. Smoking significantly reduced the time to menopause (hazard ratio, 1.61; 95% CI, 1.19-2.19; P = 0.002). AMH was a stronger predictor of time to menopause than FSH or inhibin b. CONCLUSIONS: AMH is a strong predictor of median time to menopause in late reproductive age women. Age and smoking are significant and independent contributors to the predictions of AMH.
CONTEXT: Anti-mullerian hormone (AMH) has emerged as a marker of ovarian reserve and a possible surrogate measure of reproductive aging. OBJECTIVE: The aim of the study was to evaluate the predictive value of AMH levels in determining the median time to menopause for late reproductive age women and the predictive ability of AMH compared to FSH and inhibin b. DESIGN AND SETTING: A 14-yr follow-up in the Penn Ovarian Aging Study, 1996-2010, was conducted for a randomly identified population-based cohort. SUBJECTS: A total of 401 late reproductive age women participated in the study. MAIN OUTCOME MEASURE: Observed time to menopause was measured. RESULTS: All participants were premenopausal, with a mean (SD) age of 41.47 (3.52) yr and a median AMH level of 0.68 ng/ml at baseline. AMH strongly predicted time to menopause; age further improved predictions. Among women with a baseline AMH level below 0.20 ng/ml, the median time to menopause was 5.99 yr [95% confidence interval (CI), 4.20-6.33] in the 45- to 48-yr age group and 9.94 yr (95% CI, 3.31-12.73) in the 35- to 39-yr age group. With higher baseline AMH levels above 1.50 ng/ml, the median time to menopause was 6.23 yr in the oldest age group and more than 13.01 yr in the youngest age group. Smoking significantly reduced the time to menopause (hazard ratio, 1.61; 95% CI, 1.19-2.19; P = 0.002). AMH was a stronger predictor of time to menopause than FSH or inhibin b. CONCLUSIONS:AMH is a strong predictor of median time to menopause in late reproductive age women. Age and smoking are significant and independent contributors to the predictions of AMH.
Authors: J van Disseldorp; M J Faddy; A P N Themmen; F H de Jong; P H M Peeters; Y T van der Schouw; F J M Broekmans Journal: J Clin Endocrinol Metab Date: 2008-03-11 Impact factor: 5.958
Authors: Lora E Fleming; Silvina Levis; William G LeBlanc; Noella A Dietz; Kristopher L Arheart; James D Wilkinson; John Clark; Berrin Serdar; Evelyn P Davila; David J Lee Journal: Menopause Date: 2008 Nov-Dec Impact factor: 2.953
Authors: Sandra Ledoux; Danila B Campos; Flavia L Lopes; Mira Dobias-Goff; Marie-France Palin; Bruce D Murphy Journal: Endocrinology Date: 2006-08-17 Impact factor: 4.736
Authors: Ilse A J van Rooij; Frank J M Broekmans; Gabrielle J Scheffer; Caspar W N Looman; J Dik F Habbema; Frank H de Jong; Bart J C M Fauser; Axel P N Themmen; Egbert R te Velde Journal: Fertil Steril Date: 2005-04 Impact factor: 7.329
Authors: Ellen W Freeman; Clarisa R Gracia; Mary D Sammel; Hui Lin; Lony Chong-Leong Lim; Jerome F Strauss Journal: Fertil Steril Date: 2006-11-15 Impact factor: 7.329
Authors: H Irene Su; Mary D Sammel; Ellen W Freeman; Hui Lin; Tracey DeBlasis; Clarisa R Gracia Journal: Menopause Date: 2008 Sep-Oct Impact factor: 2.953
Authors: MaryFran R Sowers; Aimee D Eyvazzadeh; Daniel McConnell; Matheos Yosef; Mary L Jannausch; Daowen Zhang; Sioban Harlow; John F Randolph Journal: J Clin Endocrinol Metab Date: 2008-07-01 Impact factor: 5.958
Authors: Michael Bonifacio; Cara K Bradley; Sonal Karia; Mark Livingstone; Mark C Bowman; Steven J McArthur Journal: J Assist Reprod Genet Date: 2015-10-14 Impact factor: 3.412
Authors: Hazel B Nichols; Donna D Baird; Frank Z Stanczyk; Anne Z Steiner; Melissa A Troester; Kristina W Whitworth; Dale P Sandler Journal: Cancer Prev Res (Phila) Date: 2015-04-14
Authors: Wenzhen Ge; Tess V Clendenen; Yelena Afanasyeva; Karen L Koenig; Claudia Agnoli; Louise A Brinton; Joanne F Dorgan; A Heather Eliassen; Roni T Falk; Göran Hallmans; Susan E Hankinson; Judith Hoffman-Bolton; Timothy J Key; Vittorio Krogh; Hazel B Nichols; Dale P Sandler; Minouk J Schoemaker; Patrick M Sluss; Malin Sund; Anthony J Swerdlow; Kala Visvanathan; Mengling Liu; Anne Zeleniuch-Jacquotte Journal: Int J Cancer Date: 2018-02-08 Impact factor: 7.396
Authors: Catherine Kim; James C Slaughter; Erica T Wang; Duke Appiah; Pamela Schreiner; Benjamin Leader; Ronit Calderon-Margalit; Barbara Sternfeld; David Siscovick; Melissa Wellons Journal: Maturitas Date: 2017-05-01 Impact factor: 4.342
Authors: Elizabeth R Bertone-Johnson; JoAnn E Manson; Alexandra C Purdue-Smithe; Anne Z Steiner; A Heather Eliassen; Susan E Hankinson; Bernard A Rosner; Brian W Whitcomb Journal: Hum Reprod Date: 2018-06-01 Impact factor: 6.918
Authors: Lauren N C Johnson; Mary D Sammel; Katherine E Dillon; Lara Lechtenberg; Allison Schanne; Clarisa R Gracia Journal: Fertil Steril Date: 2014-06-14 Impact factor: 7.329
Authors: Kimberly A Bertrand; Heather J Baer; E John Orav; Catherine Klifa; Ajay Kumar; Nola M Hylton; Erin S LeBlanc; Linda G Snetselaar; Linda Van Horn; Joanne F Dorgan Journal: Cancer Epidemiol Biomarkers Prev Date: 2016-05-09 Impact factor: 4.254