ASSOCIATION BETWEEN ANTI-MULLERIAN HORMONE AND MOTHER'S AGE AT MENOPAUSE

Abstract

To assess the association between anti-müllerian hormone (AMH) and mother’s age at natural menopause. We hypothesized that AMH levels in the daughter would be directly associated with the mother’s age at menopause. In this secondary analysis of data from the Time to Conceive (TTC) study, which was a prospective time-to-pregnancy study of women aged 30 to 44, women provided a serum sample on cycle day 2, 3, 4, or 5 that was analyzed for AMH (Ultrasensitive AMH ELISA, Ansh Labs). Time to mother’s age at menopause was the primary outcome. Censoring occurred at time of hysterectomy, endometrial ablation or uterine embolization, chemotherapy, or at age of interview if premenopausal. AMH was utilized as both a continuous variable and categorical: low (<10th percentile, 0.62 ng/ml), normal, or high (≥90th percentile, 8.86 ng/ml). A Cox proportional hazards model was used to assess the independent association between AMH and mother’s age at menopause while controlling for age, race, body mass index, education, birth control use, coffee and alcohol intake, and marijuana use. Adjusted hazard ratios (aHR) and 95% confidence intervals (CI) were presented. A HR <1 suggested a likelihood of later age at menopause while a HR >1 indicated an earlier age at menopause. Of the 689 women with a blood sample who were asked about mother’s age at menopause, 352 (51%) were not aware of their mother’s age at last menstrual period, leaving 337 women in the analysis. There were no significant differences in characteristics between those women included in the analysis and those that were not included. Median maternal age at menopause was 52 years (95% CI 52-53). There was no significant association between AMH (continuous) and mother’s age at menopause (aHR 0.97; 95% CI 0.93-1.02, p=0.21). Compared to normal AMH, a low AMH was associated with an earlier age at menopause in the mother (aHR 1.78; 95% CI 0.99-3.19, p=0.05). There was not a statistically significant association between high AMH and mother’s age at menopause (aHR 0.76; 95% CI 0.46-1.27, p=0.30). Among women in their thirties and early forties, ovarian reserve, as measured by continuous AMH, is not associated with mother’s age at menopause. However, low ovarian reserve (AMH <.62) is associated with an earlier age of menopause in the mother.