Ovarian volume and antral follicle counts as indicators of menopausal status

Objective: Recent studies suggest that ovarian volume and antral follicle numbers may be sensitive, specific, and early indicators of menopausal status. The accuracy of these markers, however, has not been compared directly to more traditional markers [age and follicle-stimulating hormone (FSH) levels]. Thus, the purpose of this study was to test whether ovarian volume and antral follicle counts are more sensitive and specific markers of menopausal status than age or FSH levels. Design: Premenopausal (n = 34) and postmenopausal (n =25) women between 40 and 54 years old received a transvaginal ultrasound for determination of ovarian volume and antral follicle numbers, provided blood for measurement of FSH levels, and completed a questionnaire. FSH levels, age, ovarian volume, and antral follicle numbers were compared using t tests. Receiver operating characteristic curves were generated to evaluate the sensitivity and specificity of each marker. Results: Postmenopausal women had significantly higher FSH levels (p ≤ 0.0001), smaller ovarian volumes (p ≤ 0.002), and fewer antral follicles (p ≤ 0.002) than premenopausal women. Ovarian volume and antral follicle numbers had similar sensitivity (27.3-100%) and specificity (3.4-92.9%) in indicating postmenopausal status as FSH levels and age. Conclusion: These data suggest that ovarian volume and antral follicle numbers may be useful indicators of menopausal status.