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Submitted on September 18, 2007
Accepted on March 5, 2008
Department of Reproductive Medicine and Gynaecology, University Medical Center Utrecht, 3508 GA Utrecht, The Netherlands; School of Mathematical Sciences, Queensland University of Technology, Brisbane, QLD 4001, Australia; Department of Internal Medicine, Erasmus Medical Center, 3015 GD Rotterdam, The Netherlands; Julius Center for Health Sciences and Primary care, University Medical Center Utrecht, 3508 GA Utrecht, The Netherlands
* To whom correspondence should be addressed. E-mail: j.vandisseldorp-2{at}umcutrecht.nl.
BACKGROUND: Serum anti-Müllerian hormone (AMH) levels are highly correlated with antral follicle counts (AFC), while being menstrual cycle independent and easily measurable. However, AMH, unlike AFC, 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 onset of menopause were obtained from the population-based Prospect-Epic cohort. Estimation of an AMH threshold to predict menopause was done by maximum likelihood using the observed (EPIC) and predicted (AMH) distributions of age at menopause. 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 predicted 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.
CONCLUSION: The similarity between observed and predicted 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.
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