Stress reduces fertility in women

In North America, 20 to 25% of women and 18 to 21% of men of childbearing age report daily psychological stress. Although previous research has suggested that stress may reduce the chances of conception, few studies have examined this association among couples in the general population.

Now, a new study by researchers at the Boston School of Public Health (BUSPH) reveals that higher levels of stress are associated with poor chances of conception for women, but not for women. men.

The study was published in American Journal of Epidemiology.

"Although this study does not clearly prove that stress causes infertility, it provides evidence to support the integration of mental health care into counseling and preconception care," says Amelia Wesselink, PhD student at BUSPH, lead author of the study.

The researchers used data from the online pregnancy study (PRESTO), a cohort of pre-adopted North American pregnancy planners who follow couples for 12 months or until pregnancy, whichever comes first. For the new study, the researchers followed 4,769 women and 1,272 men with no history of infertility and who had not tried to conceive for more than six menstrual cycles.

Researchers measured perceived stress using the 10-item Perceived Stress Scale (PSS), designed to assess how an unpredictable, uncontrollable, and overwhelming person finds their living conditions. . The items related to last month, with five response choices ranging from 0 (never) to 4 (very often), up to a total of 40, with a higher total score indicating a higher perceived level of stress. . Both partners completed the SSP initially, and women also completed the SSP at each PRESTO bi-weekly follow-up. The basic questionnaires also included a range of demographic and behavioral factors, including race / ethnicity, household income, diet, sleep, and frequency of intercourse.

On average, baseline PSS scores were about 1 point higher for women than for men, and average follow-up scores for women's PSS follow-up remained relatively constant over the 12 months in which they were participated in the study.

The researchers found that women with PSS scores of at least 25 were 13% less likely to conceive than women whose PSS scores were less than 10. This association was stronger in women who had been trying to conceive for up to two menstrual cycles before joining PRESTO compared to women who had tried for three or more cycles before registering. The association was also stronger among women under 35 years of age.

The researchers found that while the link between higher stress levels and a lower probability of conception is a cause-and-effect association, a small proportion of this association may be due to a reduced frequency of sexual intercourse and increased irregularity of the menstrual cycle.

The researchers did not find any association between the PSS score in men and the probability of conceiving. However, couples participating in the study had about 25% less chance of conceiving when the PSS score of the man was less than 10 and that of the women was greater than or equal to 20. The authors wrote that it was the first study to suggest that the "partner stress disorder" could affect the probability of conception, although the conclusion is imprecise and hypothetical.

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More information:
Amelia K Wesselink et al, Perception of Stress and Fertility: A Cohort Study Before Designing North American Couples, American Journal of Epidemiology (2018). DOI: 10.1093 / aje / kwy186