title: Anti-mullerian hormone as a predictor of time to menopause in late reproductive age women.
abstract: BACKGROUND
  Anti-mullerian hormone (AMH) has emerged as a marker of ovarian reserve and a possible surrogate measure of reproductive aging.
  
  
  OBJECTIVE
  The aim of the study was to evaluate the predictive value of AMH levels in determining the median time to menopause for late reproductive age women and the predictive ability of AMH compared to FSH and inhibin b.
  
  
  METHODS
  A 14-yr follow-up in the Penn Ovarian Aging Study, 1996-2010, was conducted for a randomly identified population-based cohort.
  
  
  METHODS
  A total of 401 late reproductive age women participated in the study.
  
  
  METHODS
  Observed time to menopause was measured.
  
  
  RESULTS
  All participants were premenopausal, with a mean (SD) age of 41.47 (3.52) yr and a median AMH level of 0.68 ng/ml at baseline. AMH strongly predicted time to menopause; age further improved predictions. Among women with a baseline AMH level below 0.20 ng/ml, the median time to menopause was 5.99 yr [95% confidence interval (CI), 4.20-6.33] in the 45- to 48-yr age group and 9.94 yr (95% CI, 3.31-12.73) in the 35- to 39-yr age group. With higher baseline AMH levels above 1.50 ng/ml, the median time to menopause was 6.23 yr in the oldest age group and more than 13.01 yr in the youngest age group. Smoking significantly reduced the time to menopause (hazard ratio, 1.61; 95% CI, 1.19-2.19; P = 0.002). AMH was a stronger predictor of time to menopause than FSH or inhibin b.
  
  
  CONCLUSIONS
  AMH is a strong predictor of median time to menopause in late reproductive age women. Age and smoking are significant and independent contributors to the predictions of AMH.
authors.affiliation: Department of Obstetrics/Gynecology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA. freemane@mail.med.upenn.edu
authors.forename: Ellen W
authors.initials: EW
authors.lastname: Freeman
authors.forename: Mary D
authors.initials: MD
authors.lastname: Sammel
authors.forename: Hui
authors.initials: H
authors.lastname: Lin
authors.forename: Clarisa R
authors.initials: CR
authors.lastname: Gracia
mesh_terms: D000328:Adult; D054304:Anti-Mullerian Hormone / Q000097:blood*; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D005500:Follow-Up Studies; D006801:Humans; D007265:Inhibins / Q000097:blood; D008593:Menopause / Q000097:blood*; D008875:Middle Aged; D011237:Predictive Value of Tests; D017697:Premenopause / Q000097:blood
chemical_list: C422364:inhibin B; D007265:Inhibins; D054304:Anti-Mullerian Hormone; D005640:Follicle Stimulating Hormone