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.

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