Testing ovarian reserve to predict age at menopause

被引:113
作者
Lambalk, C. B. [1 ]
van Disseldorp, J. [2 ]
de Konig, C. H. [3 ]
Broekmans, F. J. [2 ]
机构
[1] Vrije Univ Amsterdam, Med Ctr, Dept Reprod Med, NL-1007 MB Amsterdam, Netherlands
[2] Univ Med Ctr Utrecht, Dept Reprod Med & Gynaecol, Utrecht, Netherlands
[3] Univ Amsterdam, Acad Med Ctr, Ctr Reprod Med, NL-1105 AZ Amsterdam, Netherlands
关键词
Antral follicle count; Anti-Mullerian hormone; Follicle-stimulating hormone; Menopause; Ovarian reserve tests; Reproductive genetics; IN-VITRO FERTILIZATION; ANTI-MULLERIAN HORMONE; FOLLICLE-STIMULATING-HORMONE; STROMAL BLOOD-FLOW; ENDOTHELIAL GROWTH-FACTOR; UTERINE ARTERY EMBOLIZATION; INHIBITING SUBSTANCE LEVELS; ESTROGEN-RECEPTOR-ALPHA; MENSTRUAL-CYCLE; NATURAL MENOPAUSE;
D O I
10.1016/j.maturitas.2009.06.007
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
030301 [社会学]; 100201 [内科学];
摘要
In modern society with women delaying pregnancy, predicting the age of the natural menopause with its preceding infertility will allow making informed choices about when to try starting to have children. Also if premature menopause could be predicted in young women, strategies could be instigated to reduce the long term health risks of early estrogen deficiency. This review examines the physiology of ovarian ageing, with the menopause being the final outcome. Long and short term predictive markers of the age of the menopause and the preceding natural infertility are evaluated. Many subtle changes in the endocrine regulation of ovarian function with advancing age may seem interesting but currently are not clinically useful as a predictive test. Examples are changes in concentrations of estradiol, progesterone, luteinizing hormone (LH) and activin, as well as follicle dynamics. Other features hold more promise. Among these are chronological age, family history, anti-Mullerian hormone (AMH), poor response to in vitro fertilization (IVF), basal follicle-stimulating hormone (FSH) and the antral follicle count for long term prediction. For short term prediction, cycle shortening and occurrence of vasomotor symptoms may prove useful. To date, none of these markers has been found to have sufficient predictive accuracy in individual women. Results of new and ongoing longitudinal studies may provide better predictive models. In particular, use of genetic profiles may add to the accuracy of currently known markers. (C) 2009 Elsevier Ireland Ltd. All rights reserved
引用
收藏
页码:280 / 291
页数:12
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