'Not nearly ready for clinical application': experts question menopause prediction method.(Gynecology)

Scottish researchers have suggested that it's possible to predict the timing of menopause by measuring a woman's ovarian volume, but this proposed approach does not have any immediate clinical applications, according to two experts.

In a recently published paper, the investigators proposed that the onset of menopause could be predicted years in advance by using transvaginal ultrasound to calculate the volume of a woman's ovaries. Ovarian volume is a marker for the number of primordial follicles the patient has left, wrote the authors, Dr. W. Hamish Wallace of the Royal Hospital for Sick Children, Edinburgh, Scotland, and the University of Edinburgh; and Dr. Thomas W. Kelsey of the University of St. Andrews Fife, Scotland.

With the woman's age and a mathematical formula to predict the rate of follicular decline, it may be possible to determine when a patient's follicle population will drop to the critical number of 25,000, which is generally considered to be the menopausal threshold, they said (Hum. Reprod. 19[7]:1612-17, 2004).

Two experts in the field who were interviewed for this article stressed that the method outlined in the paper was not ready for clinical use.

"This is a large series of clinical observations that point to a certain hypothesis, but the studies that support or reject the hypothesis haven't been done yet," said Dr. Roger Pierson, professor of obstetrics, gynecology, and reproductive sciences at the University of Saskatchewan in Saskatoon.

"It's just a mathematical model based on studies in the literature, and it's not nearly ready for clinical application," agreed Dr. Sandra Carson, medical director of Baylor Assisted Reproductive Technology, Baylor College of Medicine, Houston.

Yet even the hint of a method to predict the onset of menopause has captured the public's imagination, both in the United Kingdom and North America.