title: Antral follicle count predicts natural menopause in a population-based sample: the Coronary Artery Risk Development in Young Adults Women's Study.
abstract: OBJECTIVE
  The timing of menopause is associated with multiple chronic diseases. Tools that predict this milestone have relevance for clinical and research purposes. Among infertile women, a positive relationship exists between antral follicle count (AFC) and response to controlled ovarian hyperstimulation, a marker of ovarian reserve. However, an age-independent relationship between AFC and menopause has not been demonstrated. Thus, our objective was to evaluate the relationship between AFC measured in women aged 34 to 49 years and incident natural menopause during 7 years of follow-up.
  
  
  METHODS
  The Coronary Artery Risk Development in Young Adults Study is a longitudinal community-based study (Chicago, IL; Birmingham, AL; Minneapolis, MN; and Oakland, CA) begun in 1985-1986. In 2002-2003, the Coronary Artery Risk Development in Young Adults Women's Study measured follicle-stimulating hormone (FSH) levels and performed a transvaginal ultrasound protocol that included AFC (2-10 mm follicles on both ovaries). Incident natural menopause was assessed by surveys in 2005-2006 and 2009-2010.
  
  
  RESULTS
  In our sample (n = 456), the median (interquartile range) AFC and FSH level were 5 (2-9) and 7.8 (5.6-11.0) mIU/mL, respectively, at a mean (range) age of 42 (34-49) years in 2002-2003. One hundred one women reported natural menopause by 2009-2010. In Cox models, current smoking, stable menses, FSH level higher than 13 mIU/mL, and AFC of 4 or less were independently associated with incident natural menopause. Compared with AFC higher than 4, those with an AFC of 4 or less were nearly twice as likely to have undergone menopause during 7 years of follow-up (hazard ratio, 1.89; 95% CI, 1.19-3.02) after adjustment for covariates.
  
  
  CONCLUSIONS
  AFC has been found to be independently associated with natural menopause during 7 years of follow-up after controlling for other markers of ovarian aging.
authors: Department of Medicine, Vanderbilt University, Nashville, TN, USA. Melissa.Wellons@Vanderbilt.edu
authors: Melissa F
authors: MF
authors: Wellons
authors: Gordon Wright
authors: GW
authors: Bates
authors: Pamela J
authors: PJ
authors: Schreiner
authors: David S
authors: DS
authors: Siscovick
authors: Barbara
authors: B
authors: Sternfeld
authors: Cora E
authors: CE
authors: Lewis
mesh_terms: D000328:Adult; D000375:Aging; D003327:Coronary Disease; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D008137:Longitudinal Studies; D008593:Menopause; D008875:Middle Aged; D006080:Ovarian Follicle / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D010053:Ovary / Q000502:physiology; D017697:Premenopause; D012307:Risk Factors; D014463:Ultrasonography; D016387:Women's Health
chemical_list: D005640:Follicle Stimulating Hormone