Bertone-Johnson ER, et al. - Researchers determined if anti-Müllerian hormone (AMH) levels assessed in women aged 32–44 are associated with risk of incident early natural menopause. Findings revealed strong, significant associations between lower AMH levels and higher risk of early menopause.

Methods

• In a nested case–control study within the prospective Nurses’ Health Study II cohort, researchers investigated if AMH is associated with risk of early menopause.
• Women reporting natural menopause between blood collection and age 45 were the early menopause cases (n = 327).
• Women experiencing menopause after age 45 were the controls (n = 491); these included 327 cases matched to controls on the basis of age at blood draw (±4 months) and other factors.
• In 2016, AMH levels were assayed up to 12 years before early menopause.

Results

• Multivariable conditional logistic regression models, adjusting for matching factors, suggested that body mass index, smoking, parity, oral contraceptive use, and other factors, each 0.10 ng/ml decrease in AMH was associated with a 14% higher risk of early menopause (95% confidence interval (CI) 1.10 to 1.18; P < 0.001).
• Odds ratios for early menopause for women with AMH levels of 1.5, 1.0 and 0.5 ng/ml compared to 2.0 ng/ml were 2.6, 7.5 and 23 in polynomial regression models including linear and quadratic terms for AMH (all P < 0.001).
• Researchers noted significant associations irrespective of smoking status, adiposity, infertility history and menstrual cycle characteristics.
• In addition, models assessing the predictive ability of AMH demonstrated high concordance, and C-statistics were high, ranging from 0.68 (age ≤35) to 0.93 (age 42).