Researchers have discovered a way of predicting the start of the menopause. The technique, developed by Dr Hamish Wallace, lead researcher at Edinburgh University's Department of Reproductive and Developmental Science, and Dr Thomas Kelsey, a computer scientist from the University of St Andrews, promises women a chance to plan their reproductive lives.
Ovaries develop when female fetuses are still in the womb, at about four months' gestation. Several million eggs are produced, with the total number already declining before the child is born. This reduction continues throughout early life and so, by the time of menopause, only around a thousand eggs remain, too few for a mature egg to be produced. Wallace and Kelsey found that they could predict the decline in eggs - and hence the start of menopause - from a woman's age, her hormone levels and the size of her ovaries. Ovary size can be determined by means of a transvaginal ultrasound scan, the same technology used to visualise fetuses in the womb, a relatively quick and inexpensive procedure.
The test may become routinely available at GPs' surgeries and fertility clinics, depending on the results of clinical studies already underway. Women predicted to have an early menopause could avoid missing out on motherhood, giving them the option to get pregnant before or freeze eggs or ovarian tissue for later. Further, if women are forewarned about the onset of menopause, they can prepare themselves mentally and physically for what can be a difficult time. The test should give a good prediction for most women, though it will not work for women taking the contraceptive pill, which prevents ovulation.
The research, published in the journal Human Reproduction, was aimed at developing a calculation to predict the menopausal age of cancer sufferers treated with ovary-damaging radiotherapy, but its application to the general population has since been realised. Despite the possible benefits, Adam Balen, a consultant gynaecologist, warned against relying too heavily upon such a test. 'People who want the best chance of having a family should be trying in their twenties, not leaving it until their late thirties.'
Sources and References
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