The traditional way women have detected menopause was a set of hot flashes followed by a year of no menses. But understanding when that day is approaching, and if the symptoms that you are having may mean menopause, has been a bigger challenge.
FSH testing and estrogen testing had come into wide use almost 3 decades ago. In the past decade, there has been more widespread use of the inhibin B tests. And now we have gone further with blood stream tests of a woman's serum anti-Mullerian hormones (AMH).
Inhibin B rises, but AMH decreases, as ovaries age towards menopause. In fact, in a new study, they have found that AMH decreases so evenly and steadily with aging that whether you are still fertile or not can be predicted using this test.
Researchers who quantified the changes say their work can help predict a woman's chances of pregnancy. In a November 15th online paper in "Fertility and Sterility," Dr. Seifer of Maimonides Medical Center in Brooklyn, New York, and colleagues describe their analysis of data on 17,120 women aged 24 to 50 years who presented to US fertility centers for evaluation, and they have gone into the business of predicting one's actual healthy egg supply.
Given that women are born with all the eggs they are ever going to have, it's important to know just how many are in the basket. Ultrasound testing of ovarian reserve is also part of this formula. The new research found that the AMH values decrease steadily by age, and by the time you reach 50 it's almost undetectable in the blood stream, and it goes down an almost predictable amount per year. The researchers observe that although rates of declines in median and mean AMH values were tightly correlated with age, there was a large variation within each year of age. This, they say, "continues to support the concept that AMH values reflect follicular supply relatively independent of age."
Overall, Dr. Seifer said, "This information may be helpful in setting couple's expectations regarding the challenges of conceiving, the choice of possible treatment options and probabilities of potential outcomes."
Fertil Steril. Posted online November 15, 2010. Abstract