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Anti-Mullerian Hormone and Impending Menopause in Late Reproductive Age: The Study of Women’s Health Across the Nation

Finkelstein JS1, Lee H2, Karlamangla A3, Neer RM1, Sluss PM4, Burnett-Bowie SM1, Darakananda K1, Donahoe PK5, Harlow SD6, Prizand SH1, Joffe H7, Kumar A8, Martin DE9, McConnell D10, Merrilat S6, Morrison A8, Pastore LM11, Randolph JF12, Greendale GA3, Santoro N13.

J Clin Endocrinol Metab. 2020 Jan 22. pii: dgz283. doi: 10.1210/clinem/dgz283. [Epub ahead of print]

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 Anti-Mullerian 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 two-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 <48 years old to 79% at ≥ 51 years old. 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.