predict when a woman will go through the menopause allowing her to put off
childbearing with peace of mind, a conference has heard.
By measuring hormones in the blood
researchers can plot when a women will go through the menopause and be unable
to have children naturally.
The test could liberate women from
the fear that if they put off childbearing in order to forge a career that they
may leave it too late and be disappointed.
Experts said this area of medicine
could offer women more control over their fertility in a similar way to the
Pill did in the 1960s and has “enormous sociological implications”.
The researchers said the test was accurate
to within four months and was reliable enough for doctors to use it in
day-to-day practice to help women with family planning.
Some women go through the menopause
in their late 30s or early 40s when many would still expect to be able to
Fertility doctors have consistently
warned against leaving it too late to start a family as even with IVF treatment
the chances of having a child beyond the age of 40s falls dramatically.
A team in Israel have found that
certain levels of a hormone called anti-Mullerian Hormone or AMH can indicate
when a woman will go through the menopause according to her age when the test
AMH controls the development of
follicles in the ovaries, which mature to become eggs, and can be used as a
marker of how well the ovaries are functioning.
The research based on 266 women
aged between 20 and 49 at the start of the study, plotted levels of AMH over
several years to identify at what point low AMH may predict an early menopause.
Of those women 63 went through the menopause during the study period.
The results are being presented at
the European Society of Human Reproduction and Embryology in Rome and were
accurate to within four months on average.
The maximum margin of error was
Dr. Ramezani Tehrani, who is
president of the Reproductive Endocrinology Department of the Endocrine
Research Centre and a faculty member said: “The results from our study could
enable us to make a more realistic assessment of women’s reproductive status
many years before they reach menopause. For example, if a 20-year-old woman has
a concentration of serum AMH of 2.8 nanograms per millilitre, we estimate that
she will become menopausal between 35 and 38 years old.
“To the best of our knowledge this
is the first prediction of age at menopause that has resulted from a
population-based cohort study. We believe that our estimates of ages at
menopause based on AMH levels are of sufficient validity to guide medical
practitioners in their day-to-day practice, so that they can help women with
their family planning.”
Low levels of AMH indicated women
would go through the menopause before the age of 45 while high levels suggested
the women would remain fertile until their 50s with a sliding scale in between,
the findings suggested.
Dr. Tehrani said: “Our findings
indicate that AMH is capable of specifying a woman’s reproductive status more
realistically than chronological age per se.
“Considering that this is a small
study that has looked at women over a period of time, larger studies starting
with women in their twenties and following them for several years are needed to
validate the accuracy of serum AMH concentration for the prediction of
menopause in young women.”
Stuart Lavery, consultant
gynaecologist and director of IVF Hammersmith, in London, said the research
would need verifying with larger studies but added that this area of medicine
held huge potential for women.
He agreed that if a reliable test
could be found it could liberate women in a similar way that popular contraception
“We are seeing the medicalisation
of conception, first with contraception that allowed women to have a choice
over when not to have children. This could give women more positive control
over when they can have children.
“I think this is very exciting.”
However he cautioned that the tests
were not reliable yet and women should not take a positive result that their
menopause will be late that this is a ‘cast iron guarantee’.
Many other factors affect the
ability to conceive naturally including infections which can block a woman’s
Fallopian tubes, the quality of her eggs, problems with the embryo implanting
in the womb and the quality of her partner’s sperm.