COMMENTARY

Can New Biomarkers Predict Age at Menopause and Ovarian Reserve?

JoAnn E. Manson, MD, DrPH

Disclosures

October 06, 2011

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Hello, this is Dr. JoAnn Manson, professor of medicine at Harvard Medical School and Brigham and Women's Hospital. I would like to talk with you today about the exciting potential for the relatively new use of biomarkers in predicting age at menopause, ovarian reserve, and fertility status.

A great deal of interest in the subject has arisen from several reports that have come out recently on the use of biomarkers such as antimüllerian hormone (AMH), which is produced by the ovarian follicles, and the use of inhibin B to add to other biomarkers, such as follicle-stimulating hormone and estradiol level.

This subject was also discussed at a recent multidisciplinary symposium that was held before the North American Menopause Society meetings last month. It was a 10-year follow-up to the original Stages of Reproductive Aging workshop to look at the role of these biomarkers in staging reproductive aging.

The paper that was published in the Journal of Menopause several months ago was an Iranian study that looked at AMH concentration. Participants were 266 women who were followed over a period of 6 years. All of the women were between the ages of 20 and 49 and had regular menstrual periods at the start of the study.

During the 6-year follow-up period, 63 of the women experienced menopause. The use of AMH level did add to risk prediction for age at menopause, it did add to chronological age, and was quite helpful in predicting who would and who would not go through menopause during the ensuing 6 years.

The subject of predicting age at menopause and ovarian reserve is of great interest in women who wish to delay childbearing and who wish to know their ovarian reserve. Age at menopause may also be of relevance because many health conditions are linked to age at menopause. Lower age at menopause is linked to an increased risk for cardiovascular disease and osteoporosis. Older age at menopause is linked to an increased risk for breast cancer, endometrial cancer, and possibly ovarian cancer. So, women may be able to target certain interventions for reducing risk earlier in life if they have this information about when they are likely to go through menopause.

It is clear that more research is needed. This is a very exciting subject of research. We need more information about the reliability of the assays that are used to measure these hormones, the validation studies of these assays, and studies of these hormones in adding to prediction of age at menopause and ovarian reserve in even more diverse study populations and broader age ranges of the population.

Stay tuned. This is a very exciting field. I am sure you will be hearing a lot more about the use of these and other biomarkers in helping to stage reproductive aging, and this could end up being a very important issue on which to get more research and more data.

Thank you. This is Dr. JoAnn Manson.

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