Anti-Müllerian hormone, follicle stimulating hormone, antral follicle count, and risk of menopause within 5 years

Abstract

Objective To evaluate the ability of concentration of anti-Müllerian hormone (AMH), antral follicle count (AFC), and concentration of follicle stimulating hormone (FSH) to predict the onset of menopause. Study Design The Coronary Artery Risk Development in Young Adults Study (CARDIA) Women’s Study was an ancillary study to CARDIA, a population-based study of adults aged 18–30 years followed for 3 decades. For this report, participants were women (n=426) who had attended the CARDIA year 15–16 (2000–2001) examination, had at least one ovary, were not pregnant, and underwent serum AMH and FSH measurement and transvaginal ultrasonography in 2002–2003. Main Outcome Measures The probability of menopause in 5 years based upon AMH, FSH, and AFC. Results The mean age of the women at the time of AMH, FSH, and AFC assessment was 43 years. The cumulative incidence of menopause at 25 years (or follow-up) was 27% (n=426), and the incidence within 5 years was 13% (n=55). Among women aged 45–49 years, undetectable AMH concentrations were associated with a greater than 60% probability of menopause within 5 years, whereas approximately 1/3 of women with no or just one antral follicle experienced menopause within 5 years. Both low and high concentrations of FSH were associated with greater odds of menopause than intermediate concentrations. Models with multiple markers did not improve the prediction of menopause over that afforded by models with single markers. Conclusion The ability to predict onset of menopause was improved with any of the three menopausal markers in addition to age. AMH concentrations were more closely associated with menopause than AFC or FSH.

Fecundity disorders in older women: declines in follicular development and endometrial receptivity

“…Several indicators can be used to assess ovarian reserve function, including FSH, inhibin B, AMH and AFC. The data in this study revealed that AMH and AFC were superior to menstrual cycles and FSH in evaluating ovarian function in older women, which is consistent with the results reported in most previous research [16][17]. As a woman ages, her oocyte and follicular pool declines, so AFC is a good indicator of ovarian function in women.…”

Clinical application of serum anti‐Müllerian hormone as an ovarian reserve marker: A review of recent studies

“…A recent study reported that serum AMH is superior to antral follicle count (AFC) and FSH in improving the predictive ability of the onset of menopause in combination with age . However, the population‐based cohort study with over 3000 females participants revealed that the low intraclass correlation coefficient for AMH trajectories of time to menopause (0.32) do not support the uniform AMH decline trajectory.…”

The role of antimullerian hormone in assessing ovarian damage from chemotherapy, radiotherapy and surgery

“…There is an increased likelihood for a healthy woman to reach menopause before the median age of 51 years if AMH is low for her age [ 49 ]. Conversely, if her AMH level is more than 0.02 ng/ml (0.14 pmol/l), there is minimal chance of menopause within 5 years regardless of women's age [ 50 ]. The application of a low AMH to predict the probability of menopause is more sensitive in late than in young reproductive age women, but an undetectable AMH level (using a high-sensitivity assay) is predictive of menopause within 5 years in only 60% of healthy women aged more than 45 years [ 50 ].…”