Depmann M, Faddy M J, van der Schouw Y T, Peeters P H M, Broer S L, Kelsey T W, Nelson S M, Broekmans F J M
Department of Reproductive Medicine and Gynecology (M.D., S.L.B., F.J.M.B.), Julius Center for Health Sciences and Primary Care (Y.T.v.d.S., P.H.M.P.), University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands; School of Mathematical Sciences (M.J.F.), Queensland University of Technology, Brisbane, Queensland 4001, Australia; School of Computer Science (T.W.K.), University of St Andrews, St Andrews KY16 9AJ, Scotland, United Kingdom; and School of Medicine (S.M.N.), University of Glasgow, Glasgow G12 8TA, Scotland, United Kingdom.
J Clin Endocrinol Metab. 2015 Jun;100(6):E845-51. doi: 10.1210/jc.2015-1298. Epub 2015 Apr 27.
Menopause has been hypothesized to occur when the nongrowing follicle (NGF) number falls below a critical threshold. Age at natural menopause can be predicted using NGF numbers and this threshold. These predictions support the use of ovarian reserve tests, reflective of the ovarian follicle pool, in menopause forecasting.
The objective of the study was to investigate the hypothesis that age-specific NGF numbers reflect age at natural menopause.
Histologically derived NGF numbers obtained from published literature (n = 218) and distribution of menopausal ages derived from the population-based Prospect-European Prospective Investigation into Cancer and Nutrition (Prospect-EPIC) cohort (n = 4037) were combined.
NGF data were from single ovaries that had been obtained postnatally for various reasons, such as elective surgery or autopsy. From the Prospect-EPIC cohort, women aged 58 years and older with a known age at natural menopause were selected.
There were no interventions.
MAIN OUTCOME MEASURE(S): Conformity between observed age at menopause in the Prospect-EPIC cohort and NGF-predicted age at menopause from a model for age-related NGF decline constructed using a robust regression analysis. A critical threshold for NGF number was estimated by comparing the probability distribution of the age at which the NGF numbers fall below this threshold with the observed distribution of age at natural menopause from the Prospect-EPIC cohort.
The distributions of observed age at natural menopause and predicted age at natural menopause showed close conformity.
The close conformity observed between NGF-predicted and actual age at natural menopause supports the hypothesis that that the size of the primordial follicle pool is an important determinant for the length of the individual ovarian life span and supports the concept of menopause prediction using ovarian reserve tests, such as anti-Müllerian hormone and antral follicle count, as derivatives of the true ovarian reserve.
有假说认为，当非生长卵泡（NGF）数量降至临界阈值以下时会发生绝经。可使用NGF数量和该阈值预测自然绝经年龄。这些预测支持在绝经预测中使用反映卵巢卵泡池的卵巢储备测试。
本研究的目的是调查特定年龄的NGF数量反映自然绝经年龄这一假说。
将从已发表文献中获得的组织学推导的NGF数量（n = 218）与基于人群的“前景-欧洲癌症与营养前瞻性调查”（Prospect-EPIC）队列中得出的绝经年龄分布（n = 4037）相结合。
NGF数据来自因各种原因（如择期手术或尸检）产后获得的单个卵巢。从Prospect-EPIC队列中，选择了58岁及以上且自然绝经年龄已知的女性。
无干预措施。
Prospect-EPIC队列中观察到的绝经年龄与使用稳健回归分析构建的与年龄相关的NGF下降模型预测的绝经年龄之间的一致性。通过比较NGF数量降至该阈值以下的年龄的概率分布与Prospect-EPIC队列中自然绝经年龄的观察分布，估计NGF数量的临界阈值。
自然绝经的观察年龄分布与预测年龄分布显示出密切一致性。
在NGF预测的自然绝经年龄与实际年龄之间观察到的密切一致性支持了以下假说，即原始卵泡池的大小是个体卵巢寿命长度的重要决定因素，并支持使用卵巢储备测试（如抗苗勒管激素和窦卵泡计数）作为真正卵巢储备的衍生物进行绝经预测的概念。
