Anti-mullerian hormone predicts menopause: a long-term follow-up study in normoovulatory women

J Clin Endocrinol Metab. 2011 Aug;96(8):2532-9. doi: 10.1210/jc.2010-2776. Epub 2011 May 25.


Context: It has been hypothesized that a fixed interval exists between age at natural sterility and age at menopause. Both events show considerable individual variability, with a range of 20 yr. Correct prediction of age at menopause could open avenues of individualized prevention of age-related infertility and other menopause-related conditions, like cardiovascular disease and breast carcinoma.

Objective: The aim of this study was to explore the ability of ovarian reserve tests to predict age at menopause.

Design and setting: We conducted a long-term follow-up study at an academic hospital.

Participants: A total of 257 normoovulatory women (age, 21-46 yr) were derived from three cohorts with highly comparable selection criteria.

Interventions: Anti-Müllerian hormone (AMH), antral follicle count, and FSH were assessed at time 1 (T1). At time 2 (T2), approximately 11 yr later, cycle status (strictly regular, menopausal transition, or postmenopause) and age at menopause were inventoried.

Main outcome measures: Accuracy of the ovarian reserve tests in predicting time to menopause was assessed by Cox regression, and a nomogram was constructed for the relationship between age-specific AMH concentrations at T1 and age at menopause.

Results: A total of 48 (19%) women had reached postmenopause at T2. Age, AMH, and antral follicle count at T1 were significantly related with time to menopause (P < 0.001) and showed a good percentage of correct predictions (C-statistic, 0.87, 0.86, and 0.84, respectively). After adjusting for age, only AMH added to this prediction (C-statistic, 0.90). From the constructed nomogram, it appeared that the normal distribution of age at menopause will shift considerably, depending on the individual age-specific AMH level.

Conclusions: AMH is highly predictive for timing of menopause. Using age and AMH, the age range in which menopause will subsequently occur can be individually calculated.

MeSH terms

  • Adult
  • Age Factors
  • Anti-Mullerian Hormone / blood*
  • Biomarkers / metabolism
  • Female
  • Fertility / physiology*
  • Follow-Up Studies
  • Humans
  • Menopause / metabolism*
  • Middle Aged
  • Ovulation / physiology
  • Predictive Value of Tests
  • Prospective Studies
  • Surveys and Questionnaires
  • Young Adult


  • Biomarkers
  • Anti-Mullerian Hormone