Can A Simple Blood Test Predict Menopause?
A simple doctor's-office blood test may one day be able to predict when a woman will start menopause, possibly even in women in their 20s. Pending validation in future studies, the test could help women make reproductive decisions, say the authors of a study that will be presented Monday at the annual meeting of the European Society of Human Reproduction and Embryology in Rome. But the test definitely isn't ready for prime time and may not be used primarily to guide family planning decisions, even if it is eventually brought to market, other experts say. In the study, researchers from Shahid Beheshti University of Medical Sciences, in Tehran, Iran, measured blood levels of anti-mullerian hormone in 266 women who were ages 20 to 49. AMH is proportional to the number of viable eggs left in the ovaries, which produce the hormone, says Dr. James A. Grifo, M.D., Ph.D, program director of the NYU Langone Fertility Center, in New York City. In the study, the women were tested three times over a nine-year period, and a statistical model was used to predict menopause. So far, only 63 of the 266 women in the study reached menopause during the 12-year follow-up period. Still, for these women, the test results accurately predicted menopause, give or take an average of about four months, with a maximum margin of error of 3 to 4 years (the greatest amount the test was "off"). On average, the women in the study experienced menopause at age 52. Currently menopause is defined as a woman's last menstrual period -- confirmed after a full year without periods. As such, it can be recognized only in hindsight. "It has to be a retrospective diagnosis because you never know that period you just had is going to be the last one you'll ever have," Goldstein explains. But that still doesn't mean that a premenopausal state and fertility are equivalent. Doctors commonly try to measure ovarian reserve, the amount of viable eggs still in the ovary, when trying to determine fertility. And although AMH is sometimes used to calculate ovarian reserve, it's not the preferred method. Doctors use other hormones_x0014_ for example measuring levels of follicle stimulating hormone (FSH) or estrogen_x0014_ but they still don't do the job very well at this point, Goldstein says.