Relationship of Serum Antimüllerian Hormone Concentration to Age at Menopause

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Abstract
Antimüllerian hormone (AMH), also known as müllerian inhibiting substance (MIS), is viewed as a quantitative marker of ovarian reserve. Serum AMH levels are readily measured and independent of the menstrual cycle, and they correlate closely with antral follicle counts. Unlike follicle counts, however, AMH has not been evaluated as a predictor of reproductive status. The investigators measured AMH levels in 144 normal, fertile women and assessed their correlation with age at menopause. Data on the onset of menopause were taken from a population-based cohort study, the Prospect-European Prospective Investigation into Cancer and Nutrition. The maximum likelihood approach was used to estimate an AMH threshold for predicting menopause. Predictions of age at menopause were derived from an individual woman’s AMH relative to percentiles of the distribution of AMH for a given age and the corresponding percentiles of the predictive distribution of age at menopause. Good conformity was observed between the observed distribution of age at menopause and that predicted from decreasing AMH levels. A woman with a low AMH for her age is likely to enter menopause at a younger age, between ages 41 and 44 years or 7 to 10 years before the median age of 51 years that would be expected without knowing the AMH level. A woman with a high AMH for her age can expect to become menopausal at a later age, between 51 and 53 years or up to 2 years after the median age. These findings suggest that AMH reflects reproductive age more realistically than does chronologic age alone. The similarity between observed and predicted distributions of age at menopause supports the view that AMH levels are related to the onset of menopause.

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