More women are waiting longer
to have children as they pursue college degrees and
careers or simply enjoy young adulthood without kids
That trend could have
sharp repercussions for women and couples eventually
hoping to start a family. Those who wait too long could
have trouble getting pregnant. Wouldn't it be nice for
a woman to know in advance how many fertile years she
Researchers in the United
Kingdom say they've found a revolutionary way to read
the tea leaves. By measuring a woman's ovarian volume
using ultrasound and plugging that information into
a computer model, it should be possible to predict when
a woman will enter menopause and how much time is left
on her biological clock, they said.
At least that's the theory.
"We are now looking for
funding for a clinical study to prove our hypothesis
that there is a very strong relationship between ovarian
volume and ovarian reserve/age at menopause," said Dr.
W. Hamish Wallace, a consultant pediatric oncologist
at the Royal Hospital for Sick Children in Edinburgh,
He and colleague Thomas
W. Kelsey, a senior research fellow at the University
of St. Andrews in Scotland, first unveiled their methodology
last June in the journal Human Reproduction.
The occasional headline-grabbing
tale of a 50-something woman becoming a new mother does
not erase the fact that age remains a critical factor
in determining female fertility. As a woman grows older,
her ovaries produce fewer eggs. Fertility problems affect
about a third of couples in which the woman is over
35, according to the National Women's Health Information
A woman who delays pregnancy
into her late 30s or 40s could miss the boat entirely
if menopause precedes motherhood. When her monthly periods
stop for good, she can no longer produce eggs or become
Women who've had their
ovaries surgically removed may experience menopause
at any age. For most women, menopause occurs naturally
around age 51, when the ovaries stop producing estrogen,
according to the American Menopause Foundation.
But determining the precise
onset of menopause is tricky. "Some women enter menopause
prematurely at very young ages -- even less than 30,"
said Dr. Robert Schenken, president of the American
Society for Reproductive Medicine and chairman of obstetrics
and gynecology at the University of Texas Health Science
Center at San Antonio.
Having an accurate model
for predicting when a 39-year-old will become menopausal
could influence her decision about when to become pregnant,
Schenken observed. "I think it's certainly worthy of
further study," he said.
Physicians already use
a variety of tests to evaluate female infertility, including
a blood test that detects levels of follicle-stimulating
"That can tell us how
hard the brain has to work to stimulate the ovaries,"
explained Dr. Alan Copperman, director of reproductive
medicine at Mount Sinai Medical Center in New York City.
FSH and other hormone
tests are generally administered as part of the workup
of candidates for assisted reproductive techniques,
including in vitro fertilization. But no current test
is sufficiently accurate in predicting the precise age
of menopause, fertility experts said; existing tests
provide only pieces of the puzzle.
And there is a larger
question: How many women really want to know when their
baby-making days are over? "I think a lot of people
don't want to know or, certainly, don't want to know
bad news," Copperman said.
On the other hand, now
that modern medicine has made it possible to freeze
eggs for future use, a predictive test could be quite
useful to a young woman who learns that she's less likely
to be fertile in her mid- to late-30s, he conceded.
She might consider putting away some of her eggs "almost
as an insurance policy," he suggested.
Even if further studies
validate Wallace's method for predicting menopause,
it could be quite some time before it is recognized
as a standard diagnostic tool. As far as he knows, no
physicians or clinics in the United States or the United
Kingdom are currently using it.
If you're trying to conceive,
"I do not believe this
paper gives any more information to women presently
planning therapy than already exists," said Dr. William
D. Schlaff, immediate past president of the Society
for Reproductive Endocrinology and Infertility and chief
of endocrinology and infertility at the University of
Colorado Health Sciences Center in Denver.