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Relationship of Serum Antimüllerian Hormone Concentration to Age at Menopause

Department of Reproductive Medicine and Gynaecology (J.v.D., F.J.M.B.) and Julius Center for Health Sciences and Primary Care (P.H.M.P., Y.T.v.d.S.), University Medical Center Utrecht, 3508 GA Utrecht, The Netherlands; School of Mathematical Sciences (M.J.F.), Queensland University of Technology, Brisbane, Queensland 4000, Australia; and Department of Internal Medicine (A.P.N.T., F.H.d.J.), Erasmus Medical Center, 3015 GD Rotterdam, The Netherlands

Address all correspondence and requests for reprints to: J. van Disseldorp, University Medical Center Utrecht, P.O. Box 85500, Room F.05.126, 3508 GA, Utrecht, The Netherlands. E-mail: j.vandisseldorp-2{at}umcutrecht.nl.

Background: Serum antimüllerian hormone (AMH) levels are highly correlated with antral follicle counts, while being menstrual cycle independent and easily measurable. However, AMH, unlike antral follicle counts, 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 the onset of menopause were obtained from the population-based Prospect-European Prospective Investigation into Cancer and Nutrition [Prospect-EPIC] cohort. Estimation of an AMH threshold to predict menopause was done by maximum likelihood using the observed (Prospect-EPIC) distribution of age at menopause and the predictive distribution from this AMH threshold. 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 predictive 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.

Conclusions: The similarity between observed and predictive 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.