Thursday, May 01, 2008

AMH hormone levels as a predictor of age at menopause

Huge hype today as time Magazine reports about an article from a the in the Journal of Clinical Endocrinology and metabolism.
The scientific article is titled Relationship of Serum Anti-Mullerian Hormone Concentration to Age at menopause. The Abstract of the article is below.

BACKGROUND: Serum anti-Müllerian hormone (AMH) levels are highly correlated with antral follicle counts (AFC), while being menstrual cycle independent and easily measurable. However, AMH, unlike AFC, has not been tested as yet as a predictor of reproductive status. By relating AMH levels to the age distribution of reproductive events like onset of menopause we tested this hypothesis. METHODS: AMH levels were measured in 144 fertile normal volunteers and used to determine an estimate of mean AMH as a function of age. Data on onset of menopause were obtained from the population-based Prospect-Epic cohort. Estimation of an AMH threshold to predict menopause was done by maximum likelihood using the observed (EPIC) and predicted (AMH) distributions of age at menopause. Predictions of age at menopause follow from an individual woman's AMH relative to percentiles of the distribution of AMH for a given age, and the corresponding percentiles of the predicted distribution of age at menopause. RESULTS: There was good conformity between the observed distribution of age at menopause and that predicted from declining AMH levels. CONCLUSION: The similarity between observed and predicted distributions of age at menopause supports the hypothesis that AMH levels are related to onset of menopause. Results of this study suggest that AMH is able to specify a woman's reproductive age more realistically than chronological age alone.

Let me explain the whole thing in simple words. AMH is produced by the ovaries(just as eggs are) as a woman ages the ovaries shrink so threre are less eggs and less AMH. We have known this fact for a long time . What the people in the study have done is they compared numbers in ovulating women to a control group of menopausal women from a different population. So it was not a prospective study. The right way to do this study would be to follow the same women for 20 years or more until they reach menopause.
Thus the study does not add much to our knowledge: as a general rule if you ovaries are getting smaller prematurely or you produce less eggs prematurely or your day 3 fsh goes up prematurely you are more likely to undergo menopause earlier.
So pretty much no news for most women. I think that it is common knowledge that fertility declines with age the decline is sharper after the age of 35 so if you are interested in knowing your status you can go to any reproductive endocrinologist and get any or all of these tests.

Link to Times article

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