Age at menarche a predictor of diminished ovarian function

Capsule:
There are significant associations between age at menarche and the risk of diminished ovarian function in infertile women.

Authors:
Andrea Weghofer, M.D., Ph.D., M.S., M.B.A., Ann Kim, M.S., David H. Barad, M.D., M.S., Norbert Gleicher, M.D.

Volume 100, Issue 4, Pages 1039-1043, October 2013

Abstract:

Objective:
To investigate whether age at menarche is associated with functional ovarian reserve (FOR) later in life.

Design:
Retrospective cohort study.

Setting:
Fertility center.

Patient(s):
Five hundred and two infertile women.

Intervention(s):
None.

Main Outcome Measure(s):
Levels of menarcheal age, antimüllerian hormone (AMH), follicle-stimulating hormone (FSH), and functional ovarian reserve.

Result(s):
The mean age of the patients was 38.9 ± 4.9 years, and their mean level of AMH was 1.4 ± 2.0 ng/mL and of FSH was 10.7 ± 6.1 mIU/mL. Their current age-specific diminished functional ovarian reserve (DFOR) was statistically significantly associated with early menarche, defined as age <13 years. Logistic regression analysis, adjusting for race, affirmed the higher likelihood of early age at menarche in infertile patients with DFOR. When women with DFOR were grouped into quartiles, early menarche (<25th percentile) was associated with statistically significantly higher DFOR risk than late menarche (>75th percentile).

Conclusion(s):
This study demonstrates a statistically significant impact of age at menarche on DFOR risk later in life among infertile women. The occurrence of menarche may relate to follicular pool size and/or speed of follicle recruitment, which in turn is predictive of occurrence of DFOR later in life.

  • Lauren Johnson

    Nice study that examines the relationship between with decreased ovarian reserve and age at menarche. The authors conclude that women with younger age at menarche are more likely to have lower age specific AMH levels. However, several other authors have published papers recently addressing this question with conflicting results.
    For example, a paper by Dolleman and colleagues published in JCEM in May found
    that among 2300 women, there was no association between age at menarche and
    age-specific AMH percentile. Other authors have reported increased AMH with earlier age of menarche (Bragg et al, Am J Hum Biol 2012.) This question is an interesting one that warrants further investigation.

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