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Psychological stress, stressful life events, male factor infertility, and testicular function: a cross-sectional study

  • Elvira V. Bräuner
    Affiliations
    Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

    The International Research and Research Training Centre in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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  • Loa Nordkap
    Affiliations
    Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

    The International Research and Research Training Centre in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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  • Lærke Priskorn
    Affiliations
    Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

    The International Research and Research Training Centre in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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  • Åse Marie Hansen
    Affiliations
    Department of Public Health, University of Copenhagen, Copenhagen, Denmark

    The National Research Centre for the Working Environment, Copenhagen, Denmark
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  • Anne Kirstine Bang
    Affiliations
    Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

    The International Research and Research Training Centre in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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  • Stine A. Holmboe
    Affiliations
    Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

    The International Research and Research Training Centre in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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  • Lone Schmidt
    Affiliations
    Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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  • Tina K. Jensen
    Affiliations
    Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

    The International Research and Research Training Centre in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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  • Niels Jørgensen
    Correspondence
    Reprint requests: Niels Jørgensen, Department of Growth and Reproduction, Rigshospitalet section 5064, Blegdamsvej 9, DK-2100 Copenhagen, Denmark.
    Affiliations
    Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

    The International Research and Research Training Centre in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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      Objective

      To assess the association between psychological stress and male factor infertility as well as testicular function (semen quality, serum reproductive hormones) and erectile dysfunction.

      Design

      Cross-sectional study.

      Setting

      University Hospital-based research center.

      Patients

      Men with impaired semen quality were included from infertile couples, and men with naturally conceived pregnant partners were used as a reference population.

      Interventions

      Participants completed a questionnaire on health and lifestyle, including a 14-item questionnaire about self-rated psychological stress symptoms and stressful life event (SLEs), had a physical examination performed, delivered a semen sample and had a blood sample drawn.

      Main outcomes

      Differences in stress scores (calculated from self-reported stress symptoms) and SLEs between infertile and fertile men were assessed in crude and fully adjusted linear regression models. Secondary outcomes were semen quality, serum reproductive hormones, and erectile dysfunction.

      Results

      Of 423 men, 176 (41.6%) experienced at least one SLE in the 3 months prior to inclusion (50.4%/36.9%: infertile/fertile men, P = .03); β-coefficient and 95% confidence interval for the difference between the groups on the transformed scale in fully adjusted linear regression models was 0.18 (0.06, 0.30). However, there were no differences in psychological stress symptoms between the two groups (β-coefficient and 95% confidence interval) on the transformed scale (0.14; −0.02, 0.30). No association between stress (self-reported stress symptoms and SLEs) and testicular function or with erectile dysfunction was found in any of the men.

      Conclusion

      Infertile men reported a higher number of SLEs than fertile men but did not report more psychological stress symptoms. Distress and SLEs were not associated with reduced male reproductive function.
      Estrés psicológico, eventos estresantes de la vida, factor de esterilidad masculino y función testicular: un estudio transversal

      Objetivo

      Evaluar la asociación entre estrés psicológico y factor de esterilidad masculina así como la función testicular (calidad seminal, hormonas reproductivas séricas) y la disfunción eréctil.

      Diseño

      Estudio transversal.

      Lugar

      Centro de investigación de hospital universitario.

      Pacientes

      Se incluyen hombres de parejas infértiles con mala calidad seminal y los hombres con parejas embarazadas de manera natural se utilizaron como población de referencia.

      Intervención (es)

      Los participantes completaron un cuestionario de eventos estresantes de la vida (SLE) de salud y estilo de vida, incluyendo un cuestionario de 14 preguntas de síntomas de estrés psicológico autoevaluado y SLEs, se les practicó examen físico, entregaron una muestra de semen y se les obtuvo una muestra de sangre.

      Resultados principales

      Se evaluaron las diferencias en los puntajes de estrés (calculados de reportes propios de síntomas de estrés) y SLEs entre hombre infértiles y fértiles en modelos de regresión lineal crudos y totalmente ajustados. Los resultados secundarios fueron la calidad seminal, hormonas reproductivas séricas y la disfunción eréctil.

      Resultados

      De 423 hombres, 176 (41.6%) experimentaron al menos un SLE en tres meses previos a la inclusión (50.4%/36.9%: hombres infértiles/fértiles, P = .03); β-coeficiente y 95% de intervalo de confianza para la diferencia entre los grupos en la escala transformada en modelos de regresión lineal totalmente ajustada fue de 0.18 (0.06, 0.30). Sin embargo, no hubo diferencias en síntomas de estrés psicológico entre los dos grupos (β-coeficiente y 95% de intervalo de confianza) en la escala transformada (0.14; −0.02, 0.30). No se encontró asociación entre el estrés (síntomas de estrés auto informados y SLEs) y la función testicular o con la disfunción eréctil en ninguno de los hombres.

      Conclusión (es)

      Los hombres infértiles reportaron un mayor número de SLEs con respecto a los fértiles pero no reportaron más síntomas de estrés psicológico. La angustia y los SLEs no se asociaron con la función reproductiva masculina reducida.

      Key Words

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