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- Title
Does AMH relate to timing of menopause? Results of an Individual Patient Data meta- analysis.
- Authors
Depmann, M; Eijkemans, M J C; Broer, S L; Tehrani, F Ramezani; Solaymani-Dodaran, M; Azizi, F; Lambalk, C B; Randolph, J F Jr; Harlow, S D; Freeman, E W; Sammel, M D; Verschuren, W M M; van der Schouw, Y T; Mol, B W; Broekmans, F J M
- Abstract
<bold>Context: </bold>Anti-Müllerian hormone based (AMH) age at menopause predictions remain cumbersome due to predictive inaccuracy.<bold>Objective: </bold>To perform an Individual Patient Data (IPD) meta-analysis, regarding AMH based menopause prediction.<bold>Data Sources: </bold>A systematic literature search was performed using PubMed, Embase and Cochrane databases.<bold>Study Selection: </bold>Prospective cohort studies regarding menopause prediction using serum AMH levels were selected by consensus discussion.<bold>Data Selection: </bold>Individual cases were included if experiencing a regular cycle at baseline. Exclusion criteria were hormone use and gynecological surgery.<bold>Data Synthesis: </bold>2596 women were included, 1077 experienced menopause. A multivariable Cox regression analysis assessed time to menopause (TTM) using age and AMH. AMH predicted TTM, however, added value on top of age was poor (age alone C-statistic 84%; age + AMH HR 0.66 95% CI 0.61-0.71, C-statistic 86%). Moreover, the capacity of AMH to predict early (≤45 years) and late menopause (≥55 years) was assessed. An added effect of AMH was demonstrated for early menopause (age alone C-statistic 52%; age + AMH HR 0.33, 95% CI 0.24-0.45, C-statistic 80%). A Weibull regression model calculating individual age at menopause revealed that predictive inaccuracy remained present and increased with decreasing age at menopause. Lastly, a check of non-proportionality of the predictive effect of AMH demonstrated a reduced predictive effect with increasing age.<bold>Conclusion: </bold>AMH was a significant predictor of TTM and especially of time to early menopause. However, individual predictions of age at menopause demonstrated a limited precision, particularly when concerning early age at menopause, making clinical application troublesome.
- Publication
Journal of Clinical Endocrinology & Metabolism, 2018, pN.PAG
- ISSN
0021-972X
- Publication type
journal article
- DOI
10.1210/jc.2018-00724