Psychological stress, stressful life events, male factor infertility, and testicular function: a cross-sectional study

Infertile men experienced more stressful life events than fertile men but did not report more psychological stress symptoms. No associations between stress and reduced testicular function were observed.

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Volume 113, Issue 4, Pages 865–875

Authors:

Elvira V. Bräuner, Ph.D., Loa Nordkap, Ph.D., Lærke Priskorn, Ph.D., Åse Marie Hansen, Ph.D., D.M.Sc., Anne Kirstine Bang, Ph.D., Stine A. Holmboe, Ph.D., Lone Schmidt, Ph.D., D.M.Sc., Tina K. Jensen, Ph.D., Niels Jørgensen, Ph.D.

Abstract:

Objective

To assess the association between psychological stress and male factor infertility as well as testicular function (semen quality, serum reproductive hormones) and erectile dysfunction.

Design

Cross-sectional study.

Setting

University Hospital-based research center.

Patients

Men with impaired semen quality were included from infertile couples, and men with naturally conceived pregnant partners were used as a reference population.

Interventions

Participants completed a stressful life events (SLE) questionnaire on health and lifestyle, including a 14-item questionnaire about self-rated psychological stress symptoms and SLEs, had a physical examination performed, delivered a semen sample and had a blood sample drawn.

Main outcomes

Differences in stress scores (calculated from self-reported stress symptoms) and SLEs between infertile and fertile men were assessed in crude and fully adjusted linear regression models. Secondary outcomes were semen quality, serum reproductive hormones, and erectile dysfunction.

Results

Of 423 men, 176 (41.6%) experienced at least one SLE in the 3 months prior to inclusion (50.4%/36.9%: infertile/fertile men, P = .03); β-coefficient and 95% confidence interval for the difference between the groups on the transformed scale in fully adjusted linear regression models was 0.18 (0.06, 0.30). However, there were no differences in psychological stress symptoms between the two groups (β-coefficient and 95% confidence interval) on the transformed scale (0.14; −0.02, 0.30). No association between stress (self-reported stress symptoms and SLEs) and testicular function or with erectile dysfunction was found in any of the men.

Conclusion

Infertile men reported a higher number of SLEs than fertile men but did not report more psychological stress symptoms. Distress and SLEs were not associated with reduced male reproductive function.


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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. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

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