Does anti-Müllerian hormone predict menopause

Joop Laven

Does anti-Müllerian hormone predict menopause

Joop S.E. Laven, M.D., Ph.D., Div. Reproductive Endocrinology & Infertility, Dept OBGYN, Erasmus MC, Rotterdam, The Netherlands

Abstract:

A recent meta-analysis identified a total of 3207 studies reporting on AMH serum levels and age at menopause. Forty-one, including 28 858 women, were included in the metanalysis. Of the three studies that assessed AMH for the diagnosis of menopause, one showed that undetectable AMH had equivalent diagnostic accuracy to elevated FSH. No study assessed whether AMH could be used to shorten the 12 months of amenorrhea required for a formal diagnosis of menopause. Studies assessing AMH with the onset of menopause generally indicated that lower age-specific AMH concentrations are associated with an earlier age at menopause. However, AMH alone could not be used to predict age at menopause with precision. The predicted estimates and confidence intervals were ranging from 2 to 12 years for women aged less than 40 years. The predictive value of AMH increased with increasing age, as the interval of prediction e.g. the time to menopause shortened. There is evidence that undetectable, or extremely low AMH, may aid early diagnosis of POI in young women with a family history of POI or those presenting with primary or secondary amenorrhea.

AMH might be used to study the age of menopause in population studies. The increased sensitivity of current AMH assays provides improved accuracy for the prediction of imminent menopause. Prediction of age at menopause remains imprecise when it is not imminent, although the finding of very low AMH values in young women is both of clinical value in indicating an increased risk of developing POI and may facilitate timely diagnosis.

Keywords: AMH; anti-Müllerian hormone; Fertility; Menopause; Ovarian Reserve; Premature Ovarian Insufficiency (POI).

Joop Laven

Professor Joop S.E. Laven is professor in Reproductive Endocrinology and Infertility based at Erasmus Medical Centre, Rotterdam in the Netherlands and was initially trained at the University of Utrecht in the same country. After Medical school he completed his Ph.D. thesis on clinical and experimental aspects of varicocele at Utrecht University in 1991. From 1991 till 1997 he continued his training at the University Medical Center St. Radboud in Nijmegen. In 1997 he became board certified in OBGYN (FRCOG) and moved to the Erasmus Medical Center in Rotterdam. In 2000 he became certified subspecialist Reproductive Medicine. He is a member of ESHRE, ASRM, the Endocrine Society, the Society of Gynecological Investigation (SGI) and the Royal Dutch College of Obstetrics and Gynecology. He is the past president of the Dutch Society of Reproductive Medicine. He is the president-elect of AE-PCOS society For many years he had a particular interest in the management of polycystic ovary syndrome covering the full spectrum from the effects of the syndrome during adolescence and adult life on the menstrual cycle, fertility, body weight and cosmetic aspects. During the last decade the research focussed on more fundamental effects that PCOS may have on quality of life and long-term health risks as well as the genetic basis of the disease. More recently he was also involved in Genome Wide Association Studies (GWAS) exploring the genetic basis of PCOS, premature ovarian insufficiency, menarche and menopause. He has published over 350 peer-reviewed papers and several reviews as well as chapters in books, and has delivered over 400 lectures to international scientific audiences. He is a past member of the editorial board of Human Reproduction Update, Human Reproduction and the Journal of Endocrine Society. He is a visiting professor at the University of Shandong, Shandong, China and the University of Adelaide, Australia. He is also a member of the international guideline groups for PCOS, POI and unexplained infertility within the Center of Research Excellence (WHIRL) Monash University, Melbourne, Australia.