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Stress reported to decrease fertility

A new study has found that increased stress in one’s life decreases fertility
A new study has found that increased stress in one’s life decreases fertility
Robin Wulffson, MD

As time passes for a woman desirous of pregnancy, stress increases; however, a new study has found that increased stress in one’s life decreases fertility. The findings were published on March 23 in the journal Human Reproduction by researchers affiliated with Ohio State University College of Medicine, Eunice Kennedy Shriver National Institute of Child Health and Human Development, and Texas A&M Health Science Center.

The study group comprised 401 (80%) women who, after enrollment, completed the study protocol. Of the 401 women, 373 (93%) had complete data available for analysis. On the morning following enrollment and again on the morning of the first day of menses after study enrollment. The saliva was measured for cortisol and alpha-amylase, which are biomarkers of stress. The couples then completed daily journals. The time to pregnancy (TTP) for each couple was determined. They were followed for up to 12 months while they were trying to conceive and through pregnancy if it occurred. Among the women who completed the protocol, 347 (87%) became pregnant and 54 (13%) did not. The data was adjusted for the woman’s age, race, income, as well as use of alcohol, caffeine and cigarettes while trying to conceive. The women with in the highest tertile (third) of alpha-amylase were found to have a 29% decrease in fertility (increased TTP), compared to women in the lowest tertile. The reduced fertility 0); P < 0.05]. This reduction in fecundity related to a more than two-fold increased risk of infertility among the women in the highest tertile. The investigators did not find an association between salivary cortisol and fertility.

The researchers reported that the study had a limitation due to “fiscal and logistical concerns.” They we were unable to obtain repeated saliva samples and perceived stress questionnaire data throughout the follow-up period. Thus, they were unable to determine whether stress levels increased as the women continued to fail to get pregnant. The investigators noted, however, that their ability to control for potential confounders using data from the daily journals, minimized distortion of the data.

The study authors concluded that their study was the first US study to report a prospective (forward-looking) association between salivary stress biomarkers and TTP. Furthermore, it was the first in the world to report an association between stress and infertility.

Take home message:

This study notes that chronic stress may decrease fertility. It is well-known that chronic stress can be detrimental to one’s health. Healthy lifestyle choices can reduce stress. These include avoidance of smoking as well as minimizing caffeine and alcohol intake. A regular exercise program can reduce stress, as can techniques such as meditation and yoga. Identify the stress factors in your life and determine which ones can be reduced.

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