INFERTILITY AND AGE OF MENOPAUSE IN A LONGITUDINAL COHORT OF PATIENTS WITH PRIMARY INFERTILITY

Lillian Dyre; Yan Li; Emily J. Sadecki; Yulian Zhao; Elizabeth A. Stewart; Alessandra J. Ainsworth

doi:10.1016/j.fertnstert.2025.07.418

OBJECTIVE To analyze the association between primary infertility, age at infertility diagnosis, and infertility type with age of natural menopause. MATERIALS AND METHODS The Mayo Primary Infertility Cohort (MPIC) is a retrospective cohort of 1001 patients diagnosed with primary infertility from 1980-1999 and 1001 age-matched referent patients. Patients with surgical menopause or unknown age of natural menopause were excluded from our analysis. We compared the risk of natural menopause using Cox Proportional Hazard Models with infertility status, age at infertility diagnosis, and infertility type as covariates. The association between primary infertility and early (age 40-45) and premature (age <40) menopause was analyzed with Chi-squared testing. We evaluated the association between age at natural menopause and primary infertility status, age at infertility diagnosis, and infertility type using linear regression models. RESULTS 461 MPIC subjects with primary infertility with 530 referent individuals were included in our analysis. 340 patients with infertility and 346 referent patients underwent natural menopause within the study period. After adjusting for BMI and tobacco use, patients with primary infertility had an increased risk of natural menopause (HR 1.20, 95% CI 1.03,1.39, p = 0.02) and underwent menopause one year earlier than referent individuals (95% CI -1.66, -0.38, p=0.002). Patients with primary infertility were more likely to undergo early menopause than referent patients (7.35% vs 2.89%, p = 0.01). Patients diagnosed with primary infertility at a younger age were found to have an earlier age of menopause. For each year increase in age at infertility diagnosis, patients underwent menopause 0.12 years later (95% CI 0.02, 0.22, p = 0.02). The only infertility type significantly associated with age of menopause was ovulatory dysfunction; these patients were less likely to undergo natural menopause during the study period than those with other diagnosis (HR 0.59, 95% CI 0.39-09.0, p = 0.01). CONCLUSIONS Patients with a history of primary infertility had an increased risk of natural menopause and specifically early menopause, and underwent menopause one year earlier compared to patients without a history of primary infertility. Patients with ovulatory dysfunction were less likely to undergo menopause during the study period than patients with other infertility types. The association between primary infertility and early menopause may represent a shared biologic effect of ovarian dysfunction or accelerated ovarian aging.

INFERTILITY AND AGE OF MENOPAUSE IN A LONGITUDINAL COHORT OF PATIENTS WITH PRIMARY INFERTILITY

View Online

Abstract

Details

Metrics