Monitoring reproductive aging in a 5-year prospective study

Ferrell, Rebecca J.; O’Connor, Kathleen; Holman, Darryl J.; Brindle, Eleanor; Miller, Rebecca; Rodrı́guez, Germán; Simon, James A.; Mansfield, Phyllis Kernoff; Wood, James W.; Weinstein, Maxine

doi:10.1097/01.gme.0000227859.50473.20

Cited by 18 publications

(3 citation statements)

References 35 publications

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“…Consistent with our findings, previous studies with longitudinal data have shown that levels of LH and FSH increase with reproductive and chronological age at least up to the early postmenopause, and that postmenopausal www.nature.com/scientificreports/ levels of these hormones remain higher than premenopausal levels [8][9][10]25,37 . However, across our and other studies, there is variation in whether, after a period of increase, levels then appear to remain stable [8][9][10] or decline 13,38 ; if there is a decline, the age at which this occurs seems to vary.…”

Section: Discussionsupporting

confidence: 92%

Longitudinal changes in reproductive hormones through the menopause transition in the Avon Longitudinal Study of Parents and Children (ALSPAC)

Soares

Kilpi

Fraser

et al. 2020

Sci Rep

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We characterised changes in reproductive hormones—LH, FSH, SHBG and AMH—by chronological age and time around the menopause (reproductive age) in mid-life women and explored their associations with lifestyle and reproductive factors. We used data from 1608 women from a UK cohort who had repeat hormone measures and experienced a natural menopause. Multilevel models were used to assess: (i) changes in hormones (outcomes) by reproductive age and chronological age (these age variables being the key exposures) and (ii) associations of body mass index (BMI), smoking, alcohol intake, parity and age at menarche with changes in hormones by reproductive age. Both LH and FSH increased until ~ 5 and 7 years postmenopause, respectively, after which they declined, but not to premenopausal levels. SHBG decreased slightly until ~ 4 years postmenopause and increased thereafter. AMH decreased markedly before menopause and remained low subsequently. For all hormones, the best fitting models included both reproductive and chronological age. BMI, smoking and parity were associated with hormone changes; e.g., higher BMI was associated with slower increase in LH and FSH and decrease in AMH. Reproductive and chronological age contribute to changes in LH, FSH, SHBG and AMH across mid-life in women, and BMI, smoking and parity are associated with these hormone changes.

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Section: Discussionsupporting

confidence: 92%

Longitudinal changes in reproductive hormones through the menopause transition in the Avon Longitudinal Study of Parents and Children (ALSPAC)

Soares

Kilpi

Fraser

et al. 2020

Sci Rep

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“…The normal process of reproductive ageing varies considerably among women. While some women undergo premature menopause, others have spontaneous pregnancy in their fourth decade of life [ 1 ]. This variability, currently not predictable, is summarized in the concept of ovarian reserve, a term coined more than 25 years ago by Daniel Navot [ 2 ] and present in titles of at least 1300 papers indexed on PubMed.…”

Section: Introductionmentioning

confidence: 99%

OvAge: a new methodology to quantify ovarian reserve combining clinical, biochemical and 3D-ultrasonographic parameters

et al. 2015

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BackgroundIn the last decade, both endocrine and ultrasound data have been tested to verify their usefulness for assessing ovarian reserve, but the ideal marker does not yet exist. The purpose of this study was to find, if any, a statistical advanced model able to identify a simple, easy to understand and intuitive modality for defining ovarian age by combining clinical, biochemical and 3D-ultrasonographic data.MethodsThis is a population-based observational study. From January 2012 to March 2014, we enrolled 652 healthy fertile women, 29 patients with clinical suspect of premature ovarian insufficiency (POI) and 29 patients with Polycystic Ovary syndrome (PCOS) at the Unit of Obstetrics & Gynecology of Magna Graecia University of Catanzaro (Italy). In all women we measured Anti Müllerian Hormone (AMH), Follicle Stimulating Hormone (FSH), Estradiol (E2), 3D Antral Follicle Count (AFC), ovarian volume, Vascular Index (VI) and Flow Index (FI) between days 1 and 4 of menstrual cycle. We applied the Generalized Linear Models (GzLM) for producing an equation combining these data to provide a ready to use information about women ovarian reserve, here called OvAge. To introduce this new variable, expression of ovarian reserve, we assumed that in healthy fertile women ovarian age is identical to chronological age. ResultsGzLM applied on the healthy fertile controls dataset produced the following equation OvAge = 48.05 - 3.14*AHM + 0.07*FSH - 0.77*AFC - 0.11*FI + 0.25*VI + 0.1*AMH*AFC + 0.02*FSH*AFC. This model showed a high statistical significance for each marker included in the equation. We applied the final equation on POI and PCOS datasets to test its ability of discovering significant deviation from normality and we obtained a mean of predicted ovarian age significantly different from the mean of chronological age in both groups.ConclusionsOvAge is one of the first reliable attempt to create a new method able to identify a simple, easy to understand and intuitive modality for defining ovarian reserve by combining clinical, biochemical and 3D-ultrasonographic data. Although design data prove a statistical high accuracy of the model, we are going to plan a clinical validation of model reliability in predicting reproductive prognosis and distance to menopause.Electronic supplementary materialThe online version of this article (doi:10.1186/s13048-015-0149-z) contains supplementary material, which is available to authorized users.

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“…13–18 AMH and inhibin B decline and FSH rises as a woman moves through the menopausal transition. 19–21 The levels of AMH and FSH mark later stages of reproductive aging such as early perimenopause, late perimenopause, and postmenopause. 13, 22–26 AMH is predictive of time to menopause.…”

Section: Introductionmentioning

confidence: 99%