Prediction of age at menopause in women with polycystic ovary syndrome

Abstract

Objective: Considering the role of anti-Müllerian hormone (AMH) in female fertility and its high levels in women with polycystic ovary syndrome (PCOS), the longer reproductive span of these women is in doubt. In the present study, we aimed to improve earlier predictions using a non-linear model to substantiate the question as to whether PCOS women reach menopause later.

Methods: In total, 1162 women aged 20–50 years, comprising 378 PCOS cases and 784 eumenorrheic non-hirsute women, met the eligibility criteria. A scatterplot matrix was drawn to detect the association between age and AMH; this association was explored using a fractional polynomial regression model. Model assumptions were checked by examining the distribution of the residuals and plotting the standardized residuals against the functional form of AMH.

Results: The serum concentration of AMH among PCOS participants was significantly higher than in the controls (5.4 ng/ml (IQR 2.8–9.1 ng/ml) vs. 1.4 ng/ml (IQR 0.6–2.7 ng/ml), p < 0.001). The estimated mean age at menopause was 51.4 (95% CI 45–59) years and 49.7 (95% CI 45–55) years in PCOS cases and healthy controls, respectively.

Conclusions: These findings provide the insight that, as reflected through significantly higher average levels of AMH in PCOS women, their predicted reproductive lifespan could be 2 years longer than their normo-ovulatory counterparts.

Keywords:

• Anti-Müllerian hormone
• age at natural menopause
• polycystic ovary syndrome
• fractional polynomials

Acknowledgements

The authors wish to acknowledge Ms. Niloofar Shiva for the critical editing of English grammar and syntax of the manuscript.

Conflict of interest

The authors report no conflict of interest. The authors alone are responsible for the content and writing of this paper.

Additional information

Funding

This study was supported by the Research Institute for Endocrine Sciences (RIES), Shahid Beheshti University of Medical Sciences [grant number: 348].