Related Experiment Video
Updated: May 10, 2026
Z-Scores for Assessing Ovarian Reserve in Young Patients Undergoing Fertility Preservation
Published on: October 25, 2024
Age at menarche: a predictor of diminished ovarian function?
Andrea Weghofer1, Ann Kim, David H Barad
1Department of Obstetrics and Gynecology, Medical University Vienna, Vienna, Austria; Center for Human Reproduction and Foundation for Reproductive Medicine, New York, New York.
Objective:
To investigate whether age at menarche is associated with functional ovarian reserve (FOR) later in life.
Design:
Retrospective cohort study.
Setting:
Fertility center.
Patient(S):
Five hundred and two infertile women.
Intervention(S):
None.
Main Outcome Measure(S):
Levels of menarcheal age, antimüllerian hormone (AMH), follicle-stimulating hormone (FSH), and functional ovarian reserve.
Result(S):
The mean age of the patients was 38.9 ± 4.9 years, and their mean level of AMH was 1.4 ± 2.0 ng/mL and of FSH was 10.7 ± 6.1 mIU/mL. Their current age-specific diminished functional ovarian reserve (DFOR) was statistically significantly associated with early menarche, defined as age <13 years. Logistic regression analysis, adjusting for race, affirmed the higher likelihood of early age at menarche in infertile patients with DFOR. When women with DFOR were grouped into quartiles, early menarche (<25th percentile) was associated with statistically significantly higher DFOR risk than late menarche (>75th percentile).
Conclusion(S):
This study demonstrates a statistically significant impact of age at menarche on DFOR risk later in life among infertile women. The occurrence of menarche may relate to follicular pool size and/or speed of follicle recruitment, which in turn is predictive of occurrence of DFOR later in life.
Related Concept Videos
01:28Menopause
02:07Oogenesis
01:22Oogenesis
Each primary oocyte is surrounded by a layer of pre-granulosa cells, forming what is known...
01:22Hormonal Regulation of the Menstrual Cycle
At puberty, GnRH begins a pulsatile release pattern, which triggers the anterior pituitary gland to secrete follicle-stimulating hormone (FSH) and luteinizing hormone (LH). The frequency and amplitude of GnRH pulses vary across the menstrual cycle, with faster pulses favoring LH release and slower pulses favoring FSH release.
01:29Bone Disorders
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...
01:30Hormonal Control of the Ovarian Cycle
Before puberty, the hypothalamus releases GnRH in a low frequency, low amplitude pulsatile manner. This along with the immature hypothalamic-pituitary-gonadal axis activity, results in low estrogen levels and the absence of a fully functional ovarian cycle. At puberty, GnRH secretion increases in both frequency and...