Contribution of the rate of change of antimullerian hormone in estimating time to menopause for late reproductive age women

Capsule:
The rate of change of AMH is an independent predictor of TTM in late reproductive-age women and increased precision of estimates of TTM when included with baseline AMH levels and age.

Authors:
Ellen W. Freeman, Ph.D., Mary D. Sammel, Sc.D., Hui Lin, M.S., David W. Boorman, M.S., Clarisa R. Gracia, M.D.

Volume 98, Issue 5, Pages 1254-1259.e2, November 2012

Abstract:

Objective:
To determine the rate of change of antimullerian hormone (AMH) in the late reproductive years and its associations with time to menopause (TTM). We hypothesized that the rate of change between 2 measures of AMH reflects follicular atresia and varies among women independent of age.

Design:
A 14-year follow-up.

Setting:
A randomly identified, population-based cohort (Penn Ovarian Aging Study).

Subjects:
Two measures of AMH were evaluated in survival analysis of 293 women.

Intervention:
None.

Main Outcome Measure:
Time to menopause.

Results:
The rate of AMH change was a strong independent predictor of TTM in multivariable analysis after adjusting for AMH baseline, age and smoking (hazard ratio for 1 SD change = 1.82, 95% CI: 1.56 – 2.14, P

Conclusions:
AMH rate of change was independently associated with TTM in late reproductive-age women and increased the precision of estimates of TTM when included with an AMH baseline level and age. The rate of AMH change may be a more direct surrogate than age and increases the precision of estimates of TTM during this clinically important time period.

  • Congratulations. This model of work which requires patient’s follow up for more than 10 years are very difficult to finish but specially useful for the scientific community. No question about that AMH has great advantages with respect to basal FSH and estradiol for this kind of trials, mainly because AMH doesn’t require any specific day of the cycle. But, in my opinion, we haven’t still solved the question about which of them is more reliable to test ovarian reserve, specially when the values are in the extremes. Did you measure basal FSH and estradiol in some of this patients to perform a comparison between AMH vs basal FSH and estradiol? Thank you very much.

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