The increase in the average lifespan of individuals, but not average age at menopause has lead to an increase in the number of years a woman faces the consequences of low ovarian hormone production. Because many of the physiological changes associated with menopause can be most effectively managed with early intervention, the importance of identifying biomarkers that facilitate accurate and precise predictions of the time until the final menstrual period (FMP) is now recognized.
Currently, follicle-stimulating hormone (FSH) is a widely used clinical test used to assess ovarian age but suffers from several significant limitations. First, because FSH is a pituitary hormone, and not an ovarian hormone, FSH measures ovarian reserve indirectly. Second, for clinical use FSH levels must be tested only during days 3 to 5 of a mensural cycle because FSH levels varies over 10-fold across the menstrual cycle; reciprocally with changes in ovarian production of its key regulators, estradiol and inhibins. Anti-Mullerian Hormone (AMH) testing is advantageous compared to FSH as an index of ovarian aging. This is because AMH is produced by secondary, pre-antral and early antral follicles. Thus, AMH provides a direct index of ovarian activity. AMH levels decline progressively with age and reflect functional ovarian reserve. Importantly, AMH levels are stable across the menstrual cycle and can be measured at any time without affecting the interpretation of a single blood draw to measure its level.
MenoCheck™ is an ELISA specifically designed to measure the ultra-low levels of AMH during the menopausal transition; it has a lower limit of detection than prior AMH assays. Measurements obtained using MenoCheck have been carefully validated in specimens from thousands of women participating in large women’s health studies. Reference intervals for MenoCheck measurements are based not only on chronological age but importantly also on known FMP dates, as illustrated to the right.
Clinical considerations
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