Like mother’s menopause, like daughter’s fertility decline

By Piriya Mahendra, medwireNews Reporter

A mother's age at menopause may dictate when her daughter's fertility will decline, suggests research.

A prospective cohort study has shown that the daughters of women who reach the menopause early (≤45 years) may have a more rapid than usual decline in levels of anti-Müllerian hormone (AMH) and antral follicle count (AFC), markers of a declining ovarian reserve.

"This is the first study to suggest that the age-related decline of AMH and AFC may differ between those whose mothers entered menopause before the age of 45 years and those whose mothers entered menopause after the age of 55 years," remarked lead author Janne Bentzen (Copenhagen University Hospital, Rigshospitalet, Denmark) in a press statement.

Her team found that average AMH levels declined by 8.6%, 6.8%, and 4.2% each year in women whose mothers underwent early-, normal- (46-54 years), and late-onset (>55 years) menopause, respectively.

A similar pattern was found for levels of average AFC, which declined by 5.8%, 4.7%, and 3.2% per year in women whose mothers underwent early, normal, and late menopause.

The researchers also found that levels of AMH and AFC were a significant 27.3% and 26.8% lower in women who used oral contraceptives compared with those who did not. However, Bentzen assured that the effect of oral contraceptives on ovarian reserve should be temporary and unlikely to influence the long-term decline in ovarian follicles.

Nevertheless, she said, clinicians and women should be aware of it when considering a woman's reproductive life span or fertility treatment.

The study used the cross-sectional data of 527 women with a mean age of 32.7 years whose mother's age at natural menopause was known. Serum AHM analysis and transvaginal ovarian sonography on cycle days 2-5 were used to assess the AMH and AFC levels of the participants.

The authors write in Human Reproduction: "Our data do not elucidate whether maternal age at menopause is a direct predictor of age at menopause of the offspring, or the chance of pregnancy. Nevertheless, from a biological point of view, it may be reasonable to assume that a low ovarian reserve may have a long-term effect that will shorten the reproductive lifespan."

"We therefore assume that markers such as 'maternal age at menopause' in combination with AMH or AFC, and chronological age may represent a more complete picture when evaluating the ovarian reserve of the individual. This assumption [must] await longitudinal studies before it can be put to test."

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