Stress makes it more difficult to conceive, study suggests

September 26, 2022

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Women with higher allostatic stress — an indicator of chronic stress — had lower fertility, according to data published in act obstetrics etc gynecology Scandinavia.

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“To our knowledge, this is the first study to report this association in women who generally wish to conceive from a cohort design.” Xiang Hong, PhD who holds a postdoctoral position at the Key Laboratory of Environmental Medicine and Engineering of the Ministry of Education at Southeast University in Nanjing, China, and colleagues wrote. “Our findings will help provide scientific evidence to improve women’s pre-pregnancy health through the development of appropriate management strategies.”

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Data derived from Hong X, et al.  Acta Obstet Gynecol Scand.  2022;doi:10.1111/aogs.14443.

Data derived from Hong X, et al. Acta Obstet Gynecol Scand. 2022;doi:10.1111/aogs.14443.

Identifying women trying to conceive

Hong and colleagues enrolled married couples trying to conceive who participated in the National Pre-conception Check-up Project at Gulou District Mother-Child Center in Nanjing between June 13, 2018 and May 30, 2020. Researchers identified 444 eligible women.

Participants completed a sociodemographic and pregnancy history questionnaire and provided fasting blood samples. The researchers used the blood samples and other health indicators — including systolic blood pressure, diastolic blood pressure, fasting plasma glucose, plasma cortisol, norepinephrine, interleukin-6, hypersensitive C-reactive protein, high-density lipoprotein cholesterol, and BMI — to determine allostatic stress at the baseline. By phone, they followed the participants every 3 months for 1 year to determine if they were pregnant or when their last menstrual cycle was.

Results

The mean allostatic load score was 1 on a scale of 0 to 6, with 33.8% of women scoring 0 (Group A), 35.1% scoring 1 or 2 (Group B), and 22.5% scoring 1 score of 3 or 4 (Group C) ) and 8.6% with 5 or 6 points (Group D).

Over a 12-month follow-up period, the pregnancy rate was 55.4% in Group A, 44.5% in Group B, 50.9% in Group C, and 26.9% in Group D. Adjusted for confounders, only Group D showed a statistically significant reduction in fertility compared to group A (adjusted OR = 0.41; 95% CI, 0.21-0.83).

Hong and colleagues suggested that the association between allostatic stress and time to pregnancy may be related to hypothalamic-pituitary-adrenal axis function, hypothalamic-pituitary-gonadal axis suppression, or low sexual desire during times of stress could.

“What we found offers a new idea for preconception counseling,” senior author Bei Wang, PhD, which is also affiliated with the Ministry of Education’s Key Laboratory for Environmental Medicine and Engineering, according to a press release. “But of course, assessing stress objectively is a complex scientific question, and how to intervene and reduce the effects of chronic stress is a burning issue, these are all things we need to investigate further.”

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