Caution is warranted when discussing correlations between stress and reproductive outcomes

Lawson, Angela K.

doi:10.1016/j.fertnstert.2020.07.054

Cited by 8 publications

(2 citation statements)

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“…10 While delayed childbearing may be a key factor associated with this rate of infertility, other career-specific risk factors should be considered. Despite respondents' overwhelmingly predominant belief that psychological stress may have a causal role in infertility, conclusive evidence is lacking whether this causal role exists [23][24][25][26][27] and interventions designed to reduce psychological stress have failed to demonstrate benefit. 28,29 However, lifestyle factors, such as shift work and poor sleep quality, have been proposed as factors associated with impaired fertility and pregnancy outcomes 30,31 and warrant further evaluation.…”

Section: Discussionmentioning

confidence: 99%

Childbearing, Infertility, and Career Trajectories Among Women in Medicine

et al. 2023

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ImportanceAlthough women are increasingly represented within medicine, gender disparities persist in time to promotion, achievement of academic rank, and appointment to leadership positions, with no narrowing of this gap over time. Career-specific fertility and family building challenges among women physicians may contribute to ongoing disparities and academic attrition.ObjectiveTo evaluate delayed childbearing and infertility among women in medicine and investigate the extent to which women physicians may alter career trajectories to accommodate family building and parenthood.Design, Setting, and ParticipantsThis survey study was conducted among women physicians, with surveys distributed through medical society electronic mailing lists (listserves) and social media from March to August 2022.Main Outcomes and MeasuresBaseline demographic information and fertility knowledge were assessed. Descriptive data on delayed childbearing, infertility, use of assisted reproductive technology, and career alterations to accommodate parenthood were collected. Factors associated with timing of pregnancy and family building regret were assessed using Likert-type scales. Group differences in fertility knowledge, delayed childbearing, infertility, and family building regret were evaluated using χ2 analyses.ResultsA total of 1056 cisgender women (mean [SD] age, 38.3 [7.7] years) were surveyed across level of training (714 attending physicians [67.6%] and 283 residents or fellows [26.8%]), specialty (408 surgical [38.6%] and 638 nonsurgical [60.4%] specialties), and practice setting (323 academic [45.2%], 263 private [24.9%], and 222 community [21.0%] settings). Among respondents, 1036 individuals [98.1%] resided in the US. Overall, 910 respondents (86.2%) were married or partnered and 690 respondents (65.3%) had children. While 824 physicians (78.0%) correctly identified the age of precipitous fertility decline, 798 individuals (75.6%) reported delaying family building and 389 individuals (36.8%) had experienced infertility. Concerning measures taken to accommodate childbearing or parenthood, 199 women (28.8%) said they had taken extended leave, 171 women (24.8%) said they had chosen a different specialty, 325 women (47.1%) said they had reduced their work hours, 171women (24.8%) said they had changed their practice setting, and 326 women (47.2%) said they had passed up opportunities for career advancement among those with children. Additionally, 30 women with children (4.3%) had left medicine entirely.Conclusions and RelevanceIn this survey study, women physicians reported that career-related pressures influenced the timing of childbearing and led to marked alterations to career trajectories to accommodate family building and parenthood. These findings suggest that fertility and family building concerns among women in medicine may contribute to ongoing gender disparities and attrition and represent a potentially critical area for policy reform and future change.

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Section: Discussionmentioning

confidence: 99%

Childbearing, Infertility, and Career Trajectories Among Women in Medicine

et al. 2023

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“…Due to the heterogeneity of the published data, the conclusions of these works are also contradictory. Most authors are careful in conclusions about the relationship between stress and reproductive function, based both on the data of their studies and on the general biological considerations suggesting the impossibility of complete suppression of the reproductive function during unfavorable periods due to the need for the survival of the species (Wingfield, Sapolsky, 2003;Rooney, Domar, 2018;Lawson, 2020).…”

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confidence: 99%

Psycho-emotional stress, folliculogenesis, and reproductive technologies: clinical and experimental data

et al. 2022

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Modern life, especially in large cities, exposes people to a high level of noise, high density of population, disrupted sleeping, large amount of excessive and controversial information as well as to other negative factors; all this may cause chronic psycho-emotional stress. The latest publications often use the term “Syndrome of megalopolis”, which means disruption of sleeping, high anxiety, and altered reproductive function. Medical treatment of infertility may also be considered as a stress factor, especially when infertility lasts for years and is aggravated with emotional frustration. Long-lasting distress may worsen health in general and suppress reproductive function, in particular. The review presents the data on the effects of maternal stress on folliculogenesis, especially when assisted reproductive technologies (ARTs) are used. Clinical data are presented alongside data from laboratory animal experiments. Different maternal stress models are taken into account in respect of their inf luence on oocyte maturation and embryo development. The interfering of psycho-emotional stress and reproductive function is the focus of the review. In these situations, exogenous hormones compensate for the stress-related disruption of the hypothalamic-pituitary-gonadal axis. When ARTs are implemented, stress-induced disruption of oogenesis is realized not via a decrease in hypothalamic and pituitary hormones, but by other ways, which involve paracrine mechanisms described in this review. Based on the literature analysis, one may conclude that stress negatively affects oocyte maturation in the ovary and suppresses subsequent embryo development. The role of some ovarian paracrine factors, such as BDNF, GDF-9, HB-EGF, TNF-α, and some others has been elucidated.

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Gynecology Relevant to Andrology

Knuth

2023

Andrology

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Caution is warranted when discussing correlations between stress and reproductive outcomes

Cited by 8 publications

References 5 publications

Childbearing, Infertility, and Career Trajectories Among Women in Medicine

Childbearing, Infertility, and Career Trajectories Among Women in Medicine

Psycho-emotional stress, folliculogenesis, and reproductive technologies: clinical and experimental data

Gynecology Relevant to Andrology

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