Chronic psychosocial stressors are detrimental to ovarian reserve: a study of infertile women

Pal, Lubna; Bevilacqua, Kris; Santoro, Nanette

doi:10.3109/0167482x.2010.485258

Cited by 44 publications

(34 citation statements)

References 45 publications

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“…whether infertility caused the mental symptoms observed or vice versa, cannot be made. Mental distress has been suggested to be an etiological factor in infertility [3] and has been linked to increased risk of diminished ovarian reserve [25]. However, the existing literature lends more support to the hypothesis of infertility causing mental distress than the opposite [3,7].…”

Section: Discussionmentioning

confidence: 99%

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Is infertility really associated with higher levels of mental distress in the female population? Results from the North-Trøndelag Health Study and the Medical Birth Registry of Norway

Biringer¹,

Howard²,

Keßler³

et al. 2015

Journal of Psychosomatic Obstetrics & Gynecology

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Objective: To explore the effect of ever having tried to conceive for more than 12 months on levels of anxiety and depressive symptoms and to investigate if symptom levels of anxiety and depression in infertile women who remain childless, or go on to have children, respectively, differ from symptom levels in mothers without reports of infertility. Methods: Analyses were based on information from 12 584 Norwegian women aged 19-45 years who participated in the North-Trøndelag Health Study from 1995 to 1997 and data from the Medical Birth Registry of Norway. Anxiety and depressive symptoms were measured by the Hospital Anxiety and Depression Scale. Results: Having tried to conceive for more than 12 months (ever) was weakly associated with higher levels of depressive symptoms. In the categorical analyses, women with resolved infertility had higher levels of anxiety symptoms (B ¼ 0.25 (95% confidence interval (CI) ¼ 0.04-0.47)) and voluntarily childfree had lower levels of depressive symptoms (B ¼ -0.05 (95% CI ¼ -0.50 to -0.21)) than mothers without infertility. However, women with current primary or current secondary infertility had levels of anxiety and depression not significantly different from mothers without infertility. Conclusion: At the population level, and from a longitudinal perspective, unresolved infertility is less burdensome than findings from studies on women seeking help for infertility would suggest.

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Section: Discussionmentioning

confidence: 99%

“…50 (14) 193 (55) 65 (19) 38 (11) 47 (18) 161 (61) 35 (13) 22 (8) 137 (13) 662 (61) 184 (17) 93 (9) 99 (4) 1196 (52) 700 (30) 296 (13) 1299 (15) 4841 (56) 1589 (19) 789 (9) 1632 (13) (25) 38 (4) 2318 ( smoking (all p50.05). In addition, hypothyroidism and drinking !…”

Section: Infertility and Symptom Levels Of Anxiety And Depressionmentioning

confidence: 99%

Is infertility really associated with higher levels of mental distress in the female population? Results from the North-Trøndelag Health Study and the Medical Birth Registry of Norway

Biringer¹,

Howard²,

Keßler³

et al. 2015

Journal of Psychosomatic Obstetrics & Gynecology

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“…Chronic stressors were associated with diminished ovarian reserve [12]. Stress has also been associated with poorer ovarian functioning [13] and is thought to influence menstrual cycles [14].…”

Section: Introductionmentioning

confidence: 99%

Childhood social hardships and fertility: a prospective cohort study

Harville¹,

Boynton-Jarrett²

2013

Annals of Epidemiology

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Purpose To examine the effect of lifetime social hardships on fertility. Methods Using the British National Child Development Study, a longitudinal cohort study, the impact of exposure to childhood hardships on becoming pregnant, reported infertility, and time to pregnancy was investigated. 6477 women reported on whether they had become pregnant by age 41, and 5198 women had data on at least one pregnancy. Factor analysis was used to identify six types of childhood hardships (as reported by parent, child, social worker, or teacher); retrospective report of child abuse was also examined. Logistic regression and discrete failure-time analysis was used to adjust for potential confounders. Results Never-married women were more likely to have become pregnant at some point if they had experienced more childhood hardships. Retrospectively reported child abuse was associated with an increased likelihood of having been told one was unable to have children. Among ever-married women, childhood hardships were associated with reduced fecundability, but the association was weakened by adjustment for adult social class. Conclusions The relationship between childhood adversity and adult fertility is complex. Future research should investigate pathways between characteristics of adversities and fertility.

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“…Pal et al (2010) expanded the work of Allsworth et al, examining associations between acute (serum cortisol) and chronic (history of abuse and/or drug use) psyho-social stress and biomarkers of ovarian reserve (FSH and Müllerian-Inhibiting-Substance [MIS], now referred to as AMH) in 89 pre-menopausal infertile women <42 years of age. Women were considered to have diminished ovarian reserve (DOR) if they either demonstrated early follicular phase (days 1–3) FSH levels >10 mIU/ml and/or poor ovarian response during attempts at ovarian hyperstimulation.…”

Section: Hpa Dysregulation Stress and Ovarian Functionmentioning

confidence: 98%

“…Pal et al concluded that chronic but not current stress was associated with DOR. They proposed inappropriate HPA activation as a plausible explanation for this association (Pal, Bevilacqua, & Santoro, 2010). Because a biomarker of chronic stress was not included in the study, they were unable to provide evidence supporting this theory.…”

Section: Hpa Dysregulation Stress and Ovarian Functionmentioning

confidence: 99%

Anti-Müllerian Hormone Levels and Urinary Cortisol in Women With Chronic Abdominal Pain

Hardy¹,

McCarthy²,

Fourie³

et al. 2016

Journal of Obstetric, Gynecologic & Neonatal Nursing

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Objective To explore the association of hypothalamic-pituitary-adrenal activity with ovarian functioning in women with and without chronic abdominal pain (CAP). Design and Setting A secondary data analysis was performed using data from female participants in a natural history protocol at the National Institutes of Health. Participants A total of 36 women (19 – 39 years, mean 27.11) were included in the study. Methods This pilot study was conducted using a subset of participants enrolled in a natural history protocol conducted in the Hatfield Clinical Research Center at the National Institutes of Health. The parent study included participants with and without CAP who provided a five hour urine sample for determination of cortisol levels and serum samples for determination of circulating levels of cortisol, luteinizing hormone, and follicle stimulating hormone. Chronic abdominal pain was defined as presence or absence of chronic pain for ≥ 6 months and was determined via self-report. Results Anti-Müllerian hormone (AMH) concentrations declined significantly with age as expected. When AMH levels were dichotomized as normal or abnormal (defined as higher or lower than age-specific normative ranges), there were significant associations between abnormal AMH levels and CAP and urine cortisol levels. Subjects with CAP or low urine cortisol levels were significantly more likely to have abnormal AMH levels. Conclusion Results suggest that chronic abdominal pain and hypothalamic-pituitary-adrenal dysregulation may be associated with abnormal AMH levels.

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Chronic psychosocial stressors are detrimental to ovarian reserve: a study of infertile women

Cited by 44 publications

References 45 publications

Is infertility really associated with higher levels of mental distress in the female population? Results from the North-Trøndelag Health Study and the Medical Birth Registry of Norway

Is infertility really associated with higher levels of mental distress in the female population? Results from the North-Trøndelag Health Study and the Medical Birth Registry of Norway

Childhood social hardships and fertility: a prospective cohort study

Anti-Müllerian Hormone Levels and Urinary Cortisol in Women With Chronic Abdominal Pain

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