Antimullerian Hormone and Impending Menopause in Late Reproductive Age: The Study of Women’s Health Across the Nation
Joel S. Finkelstein, Hang Lee, Arun S. Karlamangla, Robert M. Neer, Patrick M. Sluss, Sherri‐Ann M. Burnett‐Bowie, Karin Darakananda, Patricia K. Donahoe, Sioḃán D. Harlow, Sarah H Prizand, Hadine Joffe, Ajay Kumar, Deborah Martin, Daniel McConnell, Steffenie Merrilat, Anthony Morrison, Lisa M. Pastore, John F. Randolph, Gail A. Greendale, Nanette Santoro
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.