Antimullerian Hormone and Impending Menopause in Late Reproductive Age: The Study of Women's Health Across the Nation

Background: A test that helps predict the time to the final menstrual period (FMP) has been sought for many years. Objective: To assess the ability of antimullerian hormone (AMH) measurements to predictions the time to FMP. Design: Prospective longitudinal cohort study. Setting: The Study of Women's Health Across the Nation. Participants and Measurements: AMH and FSH were measured in 1537 pre- or early perimenopausal women, mean age 47.5 +/- 2.6 years at baseline, then serially until 12 months of amenorrhea occurred. AMH was measured using a 2-site ELISA with a detection limit of 1.85 pg/mL. Main Outcome Measure: Areas under the receiver operating curves (AUC) for AMH-based and FSH-based predictions of time to FMP, stratified by age. Probabilities that women would undergo their FMP in the next 12, 24, or 36 months across a range of AMH values were assessed. Results: AUCs for predicting that the FMP will occur within the next 24 months were significantly greater for AMH-based than FSH-based models. The probability that a woman with an AMH <10 pg/mL would undergo her FMP within the next 12 months ranged from 51% at h<48 years of age to 79% at >= 51 years. The probability that a woman with an AMH >100 pg/mL would not undergo her FMP within the next 12 months ranged from 97% in women <48 years old to 90% in women >= 51 years old. Conclusions: AMH measurement helps estimate when a woman will undergo her FMP, and, in general, does so better than FSH.