Anti-Mullerian hormone - a marker of upcoming menopause or a questionable guesswork?

  Vol. 38 (2) 2017 Neuro endocrinology letters Journal Article   2017; 38(2): 75-82 PubMed PMID:  28650599    Citation

: Anti-Müllerian hormone (AMH) is a protein produced by pre-antral and small antral ovarian follicles. It is an acknowledged marker of ovarian reserve and remaining reproductive capacity, commonly used in reproductive medicine. From the third decade of life, AMH serum levels decrease consecutively up to menopause. Since the standardization of commercial assays, novel contributions of that parameter are being observed. Up to date, there is no screening tool for predicting the age of natural menopause (ANM). The following literature review evaluates the utility of AMH measurement in predicting ANM. Eleven studies met the inclusion criteria (original study with at least 9 years follow-up, 150 or more participants and the usage of ELISA assay for measuring AMH). The main finding from all of those studies is that there is an undeniable correlation between lower AMH and time to menopause (TTM). Single measurement of AMH is characterized by up to 0.86 predictive capacity, 86% to 92% accuracy which may be enhanced with additional parameters. AMH level below critical threshold strongly correlates with TTM and may become undetectable few years before menopause. The highest effectiveness was proved in short-term (up to 3 years) prediction. AMH seems to be a better predictor of TTM than FSH or inhibin B. Additionally, patterns in AMH changes are individual and the evaluation of those dynamics may lead to a higher accuracy in predicting ANM. AMH has a significant potential to become a useful tool in clinical practice as a predictor of TTM and ANM, especially with regard to family planning. More studies are required before proposed models may be implemented.

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