An experimental test that appears to predict the age a woman will hit menopause decades in advance has generated much enthusiasm at the Rome meeting of the European Society of Human Reproduction and Embryology. (One British journalist was so excited that he broke the news a day before the scientists presented their findings.) Much of the hubbub surrounds the test's implications: If a woman knew when her childbearing years would end, she could take better charge of her reproductive destiny. Perhaps she would get pregnant earlier—or freeze her eggs in her late 20s—if she knew menopause was going to strike at, say, 41 instead of the average age of 51. Or she might stay off the mommy track a bit longer if her fertility was going to last until 57.
At the moment, that's all still fantasy. The menopause test, which measures levels of anti-Mullerian hormone (AMH) that controls the development of follicles in the ovaries, has been examined in just a handful of small studies. Only 63 women in the latest study presented at the meeting reached menopause during the study's 12-year run. Yet the researchers contend that their findings suggest that a low AMH level of 2.8 nanograms per milliliter in a 20-year-old means she'll hit menopause by age 38. "We believe that our estimates...are of sufficient validity to guide medical practitioners in their day-to-day practice, so that they can help women with their family planning," said study leader Ramezani Tehrani, an associate professor of endocrinology at Shahid Beheshti University of Medical Sciences in Tehran, Iran, in a statement accompanying the study. Other experts, however, say the menopause test is at least three or four years away from being used in clinical practice. That's partly because of some uncertainty in determining standard levels of this hormone and whether these levels vary from woman to woman. For example, no one knows yet whether levels of AMH differ among racial and ethnic populations. Perhaps a low level in an Iranian woman is in the normal range for an African-American. Previous studies have also shown that obese women tend to have lower levels than women of normal weight, though they may not go into menopause any earlier.
Still, the AMH test has so far proven useful in clinical practice for predicting the success of certain infertility procedures, like in vitro fertilization. (A higher level means more eggs are likely to be retrieved from the ovary, though it doesn't seem to predict the quality of the eggs.) Ovarian cancer patients may also undergo the test to determine whether chemotherapy has affected their fertility.
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But whether this hormone test will eventually be widely used to pinpoint the age of menopause remains a big unknown. If it does prove predictive, many women will no doubt be eager to learn just how long their biological clocks will keep on ticking.
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