Executive summary of the Stages of Reproductive Aging Workshop + 10: addressing the unfinished agenda of staging reproductive aging

STRAW + 10 recommended updates to the 2001 Stages of Reproductive Aging Workshop (STRAW) criteria, recommended application regardless of women’s age, ethnicity, body size or lifestyle characteristics and identified seven research priorities.

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Siobán D. Harlow, Ph.D., Margery Gass, M.D., N.C.M.P., Janet E. Hall, M.D., Roger Lobo, M.D., Pauline Maki, Ph.D., Robert W. Rebar, M.D., Sherry Sherman, Ph.D., Patrick M. Sluss, Ph.D., Tobie J. de Villiers, M.B.Ch.B., F.R.C.O.G., F.C.O.G.(SA), STRAW + 10 Collaborative Group

Volume 97, Issue 4, Pages 843-851



The aim of this article is to summarize the recommended updates to the 2001 Stages of Reproductive Aging Workshop (STRAW) criteria. The 2011 STRAW + 10 reviewed advances in understanding of the critical changes in hypothalamic-pituitary-ovarian function that occur before and after the final menstrual period.


Scientists from five countries and multiple disciplines evaluated data from cohort studies of midlife women and in the context of chronic illness and endocrine disorders on change in menstrual, endocrine, and ovarian markers of reproductive aging including antimüllerian hormone, inhibin-B, follicle-stimulating hormone, and antral follicle count. Modifications were adopted by consensus.


STRAW + 10 simplified bleeding criteria for the early and late menopausal transition, recommended modifications to criteria for the late reproductive stage (Stage −3) and the early postmenopause stage (Stage +1), provided information on the duration of the late transition (Stage −1) and early postmenopause (Stage +1), and recommended application regardless of women’s age, ethnicity, body size, or lifestyle characteristics.


STRAW + 10 provides a more comprehensive basis for assessing reproductive aging in research and clinical contexts. Application of the STRAW + 10 staging system should improve comparability of studies of midlife women and facilitate clinical decision making. Nonetheless, important knowledge gaps persist, and seven research priorities are identified.

Read the full text at: http://www.fertstert.org/article/S0015-0282(12)00187-2/fulltext

Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders.