Association of age at menarche and different causes of infertility: a retrospective study of 7634 women undergoing assisted reproductive technology.

Background: Infertility has become a world-wide public health problem. To identify women in a high-risk of infertility at an early stage when more treatments are available, early risk factors such as age at menarche (AAM) are being investigated. AAM is often used in epidemiological studies as a marker of the timing of pubertal development and the onset of the hypothalamic-pituitary-ovarian axis functions. Therefore, our study aimed to elucidate the association of AAM and different infertility causes in women undergoing assisted reproductive technology.

Methods: A total of 7643 women were retrospectively included from the reproductive hospital affiliated with Shandong University between January 2017 and December 2019. Multivariate logistic regression models and restricted cubic spline (RSC) were performed to analyze the relationship between AAM and different infertility causes. Information on variables was obtained from medical records.

Results: Compared with primary infertility, secondary infertility would 7.7% increase risk with each one-year increase in menarche age after adjusted odds ratio (OR) [95% confidence interval (CI)], 1.077 (1.036, 1.119). In primary infertility group, each one-year increase in menarche age corresponded with a 16.7% increase in PCOS risk OR (95% CI), 1.218 (1.138, 1.303). AAM of women with DOR were significantly decreased in primary and secondary infertility group [OR (95% CI), 0.832 (0.716, 0.965) and OR (95% CI), 0.720 (0.603, 0.859)], respectively compared with the reference group. Moreover, there is a non-linear dose-response relationship between DOR (P < 0.001) with AAM.

Conclusion: This study demonstrates a significant impact of AAM on endocrine-related infertility in women. Further research on the relationship between the onset of menarche and the pathogenesis of infertility is warranted.