Human Reproduction, Vol. 18, No. 3, 644-648,
March 2003
© 2003 European Society of Human Reproduction and Embryology
Subfertility reflects accelerated ovarian ageing
1 Julius Center for Health Sciences and Primary Care, 2 Department of Reproductive Medicine and 3 Department of Medical Genetics, University Medical Center Utrecht, Utrecht, The Netherlands
4 To whom correspondence should be addressed at: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, HP nr Str 6.131, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands. e-mail: H.S.Kok{at}jc.azu.nl
BACKGROUND: The aim of the study was to explore the extent to which accelerated ovarian ageing may lead to subfertility early in reproductive life and eventually cause early menopause. METHODS: The population studied (n = 2393) never used oral contraceptives, hormone replacement therapy or an intrauterine device. Logistic regression analyses were performed using age at menopause as proxy for accelerated ovarian ageing. Measures of ovarian ageing and subfertility were menstrual cycle irregularity, ever consulted a physician for fertility problems, nulliparity, uniparity, miscarriage(s) and time interval >5 years between birth of first and second child. RESULTS: For every 5 years later menopause, the probability of reporting menstrual cycle irregularity was reduced by 26% (OR = 0.74, 95% CI: 0.63–0.86); the probability of ever consulting a physician for fertility problems was reduced by 18% (OR = 0.82, 95% CI: 0.71–0.95); the probability of staying nulliparous was reduced by 22% (OR = 0.78, 95% CI: 0.64–0.96); the probability of being uniparous was reduced by 22% (OR = 0.78, 95% CI: 0.66–0.91); the probability of having a miscarriage was reduced by 11% (OR = 0.89, 95% CI: 0.79–1.01); the probability of a large time interval between birth of first two children was reduced by 27% (OR = 0.73, 95% CI: 0.61–0.89). CONCLUSIONS: Fertility problems are frequently followed by early menopause. The findings support the view that both are an expression of accelerated ovarian ageing.
Key words: age at menopause/epidemiology/ovarian ageing/reproductive life/subfertility
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