Antimullerian Hormone and Impending Menopause in Late Reproductive Age: The Study of Women's Health Across the Nation

Abstract

Background: A test that helps predict the time to the final menstrual period (FMP) has been sought for many years.

Objective: To assess the ability of antimullerian hormone (AMH) measurements to predictions the time to FMP.

Design: Prospective longitudinal cohort study.

Setting: The Study of Women's Health Across the Nation.

Participants and measurements: AMH and FSH were measured in 1537 pre- or early perimenopausal women, mean age 47.5 ± 2.6 years at baseline, then serially until 12 months of amenorrhea occurred. AMH was measured using a 2-site ELISA with a detection limit of 1.85 pg/mL.

Main outcome measure: Areas under the receiver operating curves (AUC) for AMH-based and FSH-based predictions of time to FMP, stratified by age. Probabilities that women would undergo their FMP in the next 12, 24, or 36 months across a range of AMH values were assessed.

Results: AUCs for predicting that the FMP will occur within the next 24 months were significantly greater for AMH-based than FSH-based models. The probability that a woman with an AMH <10 pg/mL would undergo her FMP within the next 12 months ranged from 51% at h<48 years of age to 79% at ≥51 years. The probability that a woman with an AMH >100 pg/mL would not undergo her FMP within the next 12 months ranged from 97% in women <48 years old to 90% in women ≥51 years old.

Conclusions: AMH measurement helps estimate when a woman will undergo her FMP, and, in general, does so better than FSH.

Keywords: aging; female reproductive endocrinology; gonadotropins; inhibin/activin/follistatin/AMH; menopause; ovaries.

Figure 1.

Mean serum AMH (upper panel) and serum FSH (lower panel) levels vs deciles of months to the FMP. AMH, antimullerian hormone; FMP, final menstrual period.