Is polycystic ovary syndrome an exception for reproductive aging?
BACKGROUND
Anti-Mullerian hormone (AMH) is increased in women with polycystic ovary syndrome (PCOS), suggesting a delay in ovarian aging. We examined AMH levels in PCOS and normo-ovulatory women in a population-based cohort over a period of 10 years and used this information to estimate their menopausal age.


METHODS
Of a subset of 1002 non-menopausal women randomly selected from the Tehran Lipid and Glucose Study, 85 cases of PCOS were diagnosed. We frequency-matched our control subjects with PCOS cases based on age and BMI. AMH levels were assessed at the time of recruitment (T1) and twice after that (T2 and T3). AMH levels were then plotted against age of the individual at the time of the measurement and the most appropriate model was selected. Menopause was calculated based on AMH levels below 0.2 ng/ml.


RESULTS
AMH levels were significantly higher in PCOS cases compared with controls at the beginning of the study (5.58 +/- 3.64 versus 4.35 +/- 2.90 ng/ml, P = 0.03), but the difference diminished considerably in subsequent assessments. The rate of AMH decline in PCOS cases decreased in the second compared with the first interval; however, no apparent change in the rate of decline was observed in controls. Estimated ages at menopause were 51 [95% confidence interval (CI), 34-81] and 49 (95% CI, 38-63) years in PCOS cases and controls, respectively.


CONCLUSIONS
The reproductive lifespan of PCOS women extends on average 2 years beyond that of normo-ovulatory women.
Tehrani
Fahimeh Ramezani
FR
Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University (MC), 24 Parvaneh, Yaman Street, Velenjak, PO Box 19395-4763, Tehran 1985717413, Iran. ramezani@endocrine.ac.ir
Solaymani-Dodaran
Masoud
M
Hedayati
Mehdi
M
Azizi
Fereidoun
F
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D054304:Anti-Mullerian Hormone / Q000378:metabolism / Q000502:physiology*; D015992:Body Mass Index; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008593:Menopause / Q000502:physiology*; D008875:Middle Aged; D011085:Polycystic Ovary Syndrome / Q000378:metabolism / Q000503:physiopathology*; D013997:Time Factors
D054304:Anti-Mullerian Hormone