STRESS & FERTILITY.pdf

Monday, February 19, 2024 STRESS & FERTILITY What is Fertility? Fertility: capacity to reproduce (entails both getting pregnant and carrying to term) Infertility:12 months trying with no pregnancy; inability to carry to term Gonads Gonads: A sex gland in which gametes are produced - gonad: ovary / t...

Monday, February 19, 2024 STRESS & FERTILITY What is Fertility? Fertility: capacity to reproduce (entails both getting pregnant and carrying to term) Infertility:12 months trying with no pregnancy; inability to carry to term Gonads Gonads: A sex gland in which gametes are produced - gonad: ovary / testis produce egg/sperm Production is regulated by various hormones - The hypothalamus releases a releasing hormone which travels to the anterior pituitary - In the anterior pituitary, LH and FSH are released - Gonads are released HPG AXIS Hypothalamus (GRH) > Anterior Pituitary (LH/FSH) > Gonads LUTEINIZING HORMONE (LH) - Too high: premature menopause/ testicular failure - Too low: failure of gonadal function - Females: LH surge: acute rise of LH which triggers ovulation - Males: Production of testosterone and affects spermatogenesis FOLLICLE-STIMULATING HORMONE (FSH) Stimulates production of germ cells - Too high: premature menopause/ testicular failure - Too low: failure of gonadal function - Females: Growth and recruitment of ovum Promotes pregnancy continuation - Males: Stimulates maturation of seminiferous tubules and spermatogenesis 1 Monday, February 19, 2024 Study — Stress suppresses reproduction function in male rats Goal: Acute vs chronic immobilization stress Results: ✓ High Glucocorticoids = high RFRP expression in the dorsomedial hypothalamus (DMH) ✓ Increase in RFRP is associated with inhibition of downstream HPG activity ✓ Low Reproductive function Study — Chronic stress condition Methods: Immobilized for 3 hrs / day for 14 days Results: ✓ Led to up-regulation of RFRP Stress suppresses reproduction function in male rats Study — Fertility of male adult rats subjected to stress (1) Procedure: rats forced to swim for 3 mins in water at 32°C daily for 15 days Tested for: testicular weight, seminal vesicle weight, ventral prostate weight Fertility assessment: control and stressed males were mated with sexually mature normal females Results: ✓ Stress caused by forced swimming did not affect fertility ✓ Stress caused by forced swimming did not impair fertility ✓ Significantly low spermatid production ✓ Prolonged stress effects spermatogenesis, (seen after a cycle of sperm production) Study — Fertility of male adult rats subjected to stress (2) Stress (immobilization) during pre-puberty 2 Monday, February 19, 2024 Procedure: rats were 40 days old rats, Immobilized for 6 hrs/day for either 15 or 60 days ; 55day-old were placed with receptive adult females to examine sexual behaviour; 100-day-old rats were mated with sexually mature females to assess fertility rates Results: ✓ Adult rats presented a significant low in fertility rates ✓ Enhances sexual performance at the onset of puberty ✓ Decrease fertility during adulthood in male rats PRENATAL STRESS (RATS) - Prenatal stress => Fewer conceptions, more spontaneous abortions and fewer viable young Offspring = low birth weight + less likely to survive the neonatal period - Influence the balance of adrenal and gonadal hormones during a critical stage of fetal hypothalamic differentiation Producing a variety of reproductive dysfunctions in adulthood ENVIRONMENTAL ASPECT Stress Related Disorders in Women Stress Related Disorders in Men Chronic anovulation Decreased sperm count Hypothalamic amenorrhea Decreased sperm motility Pseudocyesis Altered sperm morphology Stress-related eating disorders Impotence Exercise and menstrual dysfunction Ejaculatory disorders Hyperprolactinemia Decreased serum luteinizing hormone and testosterone Early pregnancy failure Study — Workplace Hazards Participants: Infertile Men (255) vs. Fertile Men (273) Results: ✓ Solvents & paintings materials, Stress, VDTs, Shift Work ✓ Stress effect in dose-response manner ✓ Sperm Motility and Morphological Index INFERTILE MONTHS VS. FERTILE MONTHS Research Question: Do women have less stress in the months they actually conceive? Hypothesis: Less Stress = Months with Conception / More = Months without 3 Monday, February 19, 2024 AGE & SOCIAL POSITION Summary: Sample: Already those with Fertility Problem (but considered reproductively able medically) Comparison: “Success” vs “Fail” Age and Social Position: Moderators Age: Age up = Less effect of stress on fertility Social Position: Lower Social Position = More effect of stress on fertility Higher Social Position = More effect of stress on Fertility Study — Sperm Quality and Stress Participants: Fertile Men (n = 744) Goal: Is sperm quality affected by major stressful events? Results: the experience of two or more life events was associated with… ✓ decreased sperm concentration, TC, and percent motile sperm ✓ increased likelihood of classification below WHO thresholds for ‘‘normal’’ for concentration, motility, and morphology Effects of stress on sperm quality - Emotional stress plays a detrimental role on fertility - The ejaculate of 20 men was studied the number of “healthy” sperm was significantly reduced in participants who were depicted as being stressed The participants were divided into 2 groups, where one group received Conveyer of Modulating Radiance (CRM) therapy The results show that the number of “healthy” sperm was significantly higher after the therapy Infertility which causes stress which leads to more infertility Stress, gender & fertility - Women experiencing social pressure for motherhood view infertility as more stressful - Research has shown that working out of the home is beneficial to women - Women whose roles are limited pending motherhood, may experience infertility experience more distress than women engaged in multiple roles 4 Monday, February 19, 2024 Inability to conceive: has been depicted as role failure and as socially stigmatizing - This produces stressors on the need to conceive - If a women cannot conceive a child she will become increasingly more stressed which will reduce her chances of conceiving - Infertile wives perceive their fertility problem as much more stressful than their husbands - Infertile wives felt themselves as being more responsible for the infertility Husbands also attributed the responsibility to their wives This feeling of inadequacy led the women to stress even more about getting pregnant which isn’t beneficial to fertility STRESS ÈFERTILITY PROBLEMS - Excessive emotional stress can cause chronic anovulation - Elevated cortisol levels are associated with amenorrhea DISTRESS & FERTILITY - Potential predictors of distress Gender role identity and infertility Career role salience and infertility Social pressure for motherhood and infertility Study — Predictors of distress in women being treated for infertility Participants: 119 women (from 23-49 yo) Results: ✓ 42% of the participants in this study experienced clinically significant levels of distress ✓ 62% were considered to be clinically symptomatic ✓ Participants tended to view infertility as very stressful Stress & Miscarriage - Stress may lead to miscarriage in pregnant women - Compared with women with an intermediate level of psychological stress during pregnancy, women with a high level of stress had 80% increased risk of stillbirth DIFFERING OUTCOMES - Women reporting high stress did not have an higher risk of miscarriage when looking at stress alone - Women under stress were more likely to use drugs, which might be risk factors for miscarriage independently Summary - Stress influences the HPG axis leading to a decrease in gonad functioning - Environmental factors seem to play a role in stress related to reproductive difficulties 5 Monday, February 19, 2024 - Difficulty conceiving or carrying to term, leads to stress about infertility which leads to increased future fertility problems 6