Depressive symptomatology, psychological stress, and ovarian reserve

Abstract

Objective To examine psychological factors in relation to antral follicle count (AFC), a marker of ovarian reserve, in a multiethnic sample of 683 pre-menopausal women in the Ovarian Aging (OVA) Study. Methods In cross-sectional analyses, linear regression was performed to determine whether AFC decline across women varied over levels of depression as well as depression in combination with psychological stress. The total and subscale scores of the Center for Epidemiological Studies Depression Scale (CESD) were used to measure depression and the Perceived Stress Scale was used to measure psychological stress. Results Following covariate-adjustment, the 2-way interaction of age-x-positive affect and the 3-way interaction of age-x-positive affect-x-stress were related to AFC (b = 0.047, p = .036; b = 0.012, p = .099, respectively). In stratified analyses, stress was related to AFC in women with low positive affect (b = −.070, p = .021) but not in women with high positive affect (b = .018, p = .54). AFC decline across women was progressively higher in women with low positive affect who reported low (−0.747 follicles/year), mid (−0.920 follicles/year), and high (−1.112 follicles/year) levels of stress. Results examining the CESD total and remaining subscale scores were all non-significant (p’s > .05). Conclusions Cross-sectional evidence suggests that 1) women with low positive affect may experience accelerated AFC decline and 2) low positive affect may be a vulnerability factor, or, alternatively, high positive affect may be a protective factor, in moderating the negative effects of psychological stress on AFC decline.

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“…Chronic stress leads to a state of disrupted homeostasis, under which reproductive function may be impaired due to the central and peripheral actions of stress hormones. This imbalance has been linked to various reproductive dysfunctions ranging from mild disruption of menstrual cycles and polycystic ovary syndrome, all of which have been associated with an increased risk of gynecological malignancies such as ovarian and uterine cancers [3-9]. The profound effect of stress on human reproductive/endocrine physiology and the putative link to cancer has led scientists to examine the molecular connections between the neuro-endocrine response and the development of gynecological cancers.…”

Is There a Relationship Between Ovarian Reserve Tests with Depression and Anxiety Scales?

“…Higher BMI was also demonstrated to associate with psychiatric disorders and co-morbidity in various studies. [17][18][19] However, there are some limitations of the present study. One of the limitations of the present study was the small sample size.…”

“…One study investigated psychological factors in relation to antral follicle count, which is an important marker of ovarian reserve, in 683 premenopausal women in Ovarian Aging Study. 17 Their results suggested that there are negative effects of psychological stress on antral follicle count, thus on ovarian reserve. Nevertheless, to the best of our knowledge the present study is the first one investigating whether there was an association between ovarian reserve tests and depression and anxiety scales in infertile women.…”

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“…Daily stress was also associated with lower luteal phase progesterone and higher odds of anovulation. Conversely, Bleil et al (2012) found that psychological stress was related to higher antral follicle count (AFC), a measure of ovarian reserve, among younger women and greater AFC decline across women. They proposed a model by which high stress promotes reproductive readiness in the short term (i.e.…”

“…While it is well established that psychological stress interrupts normal reproductive functioning (An, Sun, Li, Zhang, & Ji, 2013; Kalantaridou et al, 2010; O’Connor et al, 2011; Whirledge & Cidlowski, 2013), the biological mechanisms underlying this effect are poorly understood (Bleil et al, 2012; Lynch, Sundaram, Buck Louis, Lum, & Pyper, 2012). The purpose of this pilot study was to explore the association between HPA activity and ovarian reserve (AMH) in women with CAP.…”