Women’s Health: January 2021

Women with early ovarian aging may have increased risks for other age-related diseases

Michael Monostra

Dec. 30, 2020 (Endocrine Today) — Women with early ovarian aging are more likely to incur age-related diseases than those with normal ovarian aging, according to study results published in Human Reproduction.

“These data demonstrate that young women with early ovarian aging, defined as low oocyte output after follicle-stimulating hormone stimulation, have increased morbidity and mortality, and strongly support the hypothesis that low ovarian reserve may be an early and useful marker of later health issues,” Mette Wulf Christensen, a PhD student in the department of gynecology and obstetrics at Aarhus University Hospital in Denmark, and colleagues wrote. “Morbidity and mortality in relation to premenopausal assessment of ovarian reserve has not previously been thoroughly studied.”

After adjusting for confounders, women with early ovarian aging had an increased risk for any age-related event, cardiovascular disease and osteoporosis.

Christensen and colleagues conducted a register-based study of women aged 37 years and younger who had their first in vitro fertilization or intracytoplasmic sperm injection at a Danish fertility clinic from 1995 to 2014. Participants were divided into an early ovarian aging group (n = 1,222) and a normal ovarian aging group (n = 16,385). The early group included women with five oocytes or fewer in two or more follicle-stimulating hormone (FSH) cycles and no cycles with six or more oocytes collected in the first year after assisted reproductive treatment. The normal group included participants with eight or more oocytes in any FSH cycles 1 year after assisted reproductive treatment.

Researchers evaluated both groups for their risks for age-related events, including cardiovascular disease, osteoporosis, type 2 diabetes, cancer, cataract, Alzheimer’s disease, Parkinson’s disease and death by any cause. The Charlson Comorbidity Index and grant of early retirement benefit were markers of age-related events.

The early ovarian aging group had a greater risk for any age-related event compared with the normal aging cohort (adjusted HR = 1.24; 95% CI, 1.08-1.43). After adjusting for confounders, women with early ovarian aging were at increased risk for CVD (aHR = 1.44; 95% CI, 1.19-1.75) and osteoporosis (aHR = 2.45; 95% CI, 1.59-3.9). No association was found between early ovarian aging and an increased risk for type 2 diabetes. Associations between the two groups for Charlson Comorbidity Index, early retirement benefit, cancer, death by any cause and other age-related diseases were not significant.

Women in the early aging group were at increased risk for age-related events with four or fewer oocytes (aHR = 1.21; 95% CI, 1.01-1.44) and three or fewer oocytes (aHR = 1.3; 95% CI, 1.04-1.63). For the four or fewer oocytes group, the risks for CVD (aHR = 1.54; 95% CI, 1.22-1.93) and osteoporosis were also elevated (aHR = 2.3; 95% CI, 1.28-4.13). Women with three or fewer oocytes had the highest risks for CVD (aHR = 1.78; 95% CI, 1.33-2.37) and osteoporosis (aHR = 2.64; 95% CI, 1.27-5.47).

“Low ovarian reserve may be a useful marker of later health issues,” the researchers wrote. “Counselling this group of patients [with early ovarian aging] at the fertility clinics may therefore be important to initiate preventative initiatives, such as lifestyle changes and/or use of hormone replacement therapy, to reduce the adverse health risks associated with early menopause.”

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