Anti-Müllerian Hormone and Inhibin B in the Definition of Ovarian Aging and the Menopause Transition

Abstract

Previous reports have indicated that anti-Müllerian hormone (AMH) and inhibin B may be biomarkers of ovarian reserve and reproductive aging. Few studies have assessed the role of AMH and inhibin B as ovarian landmarks of menopausal transition, especially with a longitudinal design. The authors hypothesized that AMH and inhibin B could be endocrine biomarkers providing an ovarian frame during transition from the initiation of menopause to the final menstrual period (FMP). This longitudinal study evaluated the transition from premenopause to the FMP in 50 women who had 6 consecutive annual measurements of AMH, inhibin B, and follicle stimulating hormone (FSH) before their transition to FMP. Commencing in 1995, 300 follicular phase specimens were assayed for AMH, inhibin B, and FSH during the annual visits by the pre- and perimenopausal women before their documented transition to the FMP. Analysis of the 6 time points before the FMP revealed a significant decline over time in logAMH longitudinal serum levels for both observed values and values below detection (P < 0.0001 and P < 0.0001, respectively). Baseline logAMH levels were also associated with age at FMP (P < 0.035). Like AMH, the loginhibin B serum levels also declined with time to FMP for both observed values and values below detection (P < 0.0001 and P < 0.0003, respectively). Unlike AMH, no significant association was found between loginhibin B baseline levels or profile over time values and the age at FMP. The investigators conclude from these findings that AMH may be an endocrine biomarker of follicle depletion and minimal ovarian reserve that signals the onset of the late stage of the menopause transition.