title: Subfertility reflects accelerated ovarian ageing.
abstract: BACKGROUND
  The aim of the study was to explore the extent to which accelerated ovarian ageing may lead to subfertility early in reproductive life and eventually cause early menopause.
  
  
  METHODS
  The population studied (n = 2393) never used oral contraceptives, hormone replacement therapy or an intrauterine device. Logistic regression analyses were performed using age at menopause as proxy for accelerated ovarian ageing. Measures of ovarian ageing and subfertility were menstrual cycle irregularity, ever consulted a physician for fertility problems, nulliparity, uniparity, miscarriage(s) and time interval >5 years between birth of first and second child.
  
  
  RESULTS
  For every 5 years later menopause, the probability of reporting menstrual cycle irregularity was reduced by 26% (OR = 0.74, 95% CI: 0.63-0.86); the probability of ever consulting a physician for fertility problems was reduced by 18% (OR = 0.82, 95% CI: 0.71-0.95); the probability of staying nulliparous was reduced by 22% (OR = 0.78, 95% CI: 0.64-0.96); the probability of being uniparous was reduced by 22% (OR = 0.78, 95% CI: 0.66-0.91); the probability of having a miscarriage was reduced by 11% (OR = 0.89, 95% CI: 0.79-1.01); the probability of a large time interval between birth of first two children was reduced by 27% (OR = 0.73, 95% CI: 0.61-0.89).
  
  
  CONCLUSIONS
  Fertility problems are frequently followed by early menopause. The findings support the view that both are an expression of accelerated ovarian ageing.
authors.affiliation: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, HP nr Str 6.131, Heidelberglaan 100, 3585 CX Utrecht, The Netherlands. H.S.Kok@jc.azu.nl
authors.forename: Helen S
authors.initials: HS
authors.lastname: Kok
authors.forename: Kristel M
authors.initials: KM
authors.lastname: van Asselt
authors.forename: Yvonne T
authors.initials: YT
authors.lastname: van der Schouw
authors.forename: Diederick E
authors.initials: DE
authors.lastname: Grobbee
authors.forename: Egbert R
authors.initials: ER
authors.lastname: te Velde
authors.forename: Peter L
authors.initials: PL
authors.lastname: Pearson
authors.forename: Petra H M
authors.initials: PH
authors.lastname: Peeters
mesh_terms: D000022:Abortion, Spontaneous / Q000453:epidemiology; D017677:Age Distribution; D000375:Aging; D001721:Birth Intervals; D005260:Female; D006801:Humans; D015994:Incidence; D007247:Infertility, Female / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D008594:Menopause, Premature; D008599:Menstruation Disturbances / Q000453:epidemiology; D008875:Middle Aged; D010053:Ovary / Q000503:physiopathology*; D010298:Parity; D011336:Probability