Early menopause in mothers of children with Down syndrome?

Objective: To investigate whether having a Down syndrome pregnancy at a relatively young age is associated with lower ovarian reserve as reflected by lower antimüllerian hormone (AMH) levels and the occurrence of earlier menopause.

Design: Retrospective, case control study.

Setting: Not applicable.

Patient(s): Two hundred twenty mothers (118 trisomy cases, 102 controls).

Intervention(s): Questionnaire and serum AMH measurement.

Main outcome measure(s): Serum AMH levels and menopause, defined as not having a menstrual cycle for at least 1 year.

Result(s): The participant response rate was 93%. After applying the exclusion criteria, 144 women were evaluable (73 trisomy cases, and 71 controls). The baseline characteristics of the women were not statistically significantly different. More women with a Down syndrome pregnancy had an AMH level below 0.5 μg/L, a difference that was statistically significant. Eleven women (15.1%) in the Down syndrome group had reached menopause compared with 9 (12.7%) of the controls.

Conclusion(s): Women who have had a Down syndrome pregnancy at a younger age show signs of limited ovarian reserve, as evidenced by their frequently having lower AMH levels. The study has found no obvious signs of early menopause thus far. Whether their age at menopause is within the normal range remains to be determined.