Ovarian reserve tests in the prediction of the fertile lifespan and current fertility

Abstract

Widely used ovarian reserve tests do not predict age at menopause or current fertility This thesis assesssed the capacity of ovarian reserve tests in the prediction of the fertile life span and current fertility. Ovarian reserve tests of interest were anti-Müllerian hormone (AMH), the antral follicle count and follicle stimulating hormone. A strong relation between the non-growing follicle pool and age at menopause was demonstrated, suggestive of a possible relation between ovarian reserve tests and age at menopause. However, no clinically relevant predictive effect for ovarian reserve tests in the prediction of menopause, or the fertile life span, could be observed. Although AMH was significantly capable of predicting menopause, the accompanying wide prediction interval, the fact that AMH did not predict the very early or late ages at menopause and the fact that AMH lost its predictive effect with increasing age, resulted in a high level of imprecision of AMH based age at menopause prediction. Furthermore, the predictive effect of ovarian reserve tests in the prediction of time to pregnancy was researched in a cohort of healthy pregnancy planners. In this study too, no predictive effect of ovarian reserve tests could be demonstrated. Based on the results of this thesis, we advise against the use of AMH (and other ovarian reserve tests) in the prediction of menopause, the fertile life span and current fertility. This thus includes an advise against the use AMH-based home fertility kits.