[The level of the stress biomarker salivary alpha amylase is correlated with semen quality in infertile young men].

Objective: To investigate the relationship between the level of the stress biomarker salivary alpha amylase (SAA) and semen quality in infertile young men. METHODS: Totally, 313 infertile and 96 normal healthy men, aged 20－40 years old, were enrolled in this study. The SAA levels and semen parameters of the subjects were measured and compared between the two groups. RESULTS: Compared with the normal healthy controls, the young infertility patients showed a significantly higher SAA level (ï¼»141.04 ± 44.13ï¼½ vs ï¼»151.48 ± 38.42ï¼½ µmol/L, P < 0.05) and percentage of immotile sperm (IMS) (ï¼»39.98 ± 14.53ï¼½% vs ï¼»64.48 ± 26.32ï¼½%, P < 0.05), but lower sperm concentration (ï¼»44.23 ± 21.63ï¼½ vs ï¼»32.42 ± 23.07ï¼½ ×106/ml, P < 0.05) and percentage of progressively motile sperm (PMS) (ï¼»52.13 ± 15.42ï¼½% vs ï¼»27.91 ± 21.22ï¼½%, P < 0.05). Sperm concentration (ï¼»26.33 ± 31.83ï¼½ vs ï¼»35.28 ± 27.70ï¼½ ×106/ml, P < 0.05) and the percentage of PMS were remarkably lower in the infertile men with a high than in those with a low SAA level (ï¼»19.85 ± 21.55ï¼½% vs ï¼»31.70 ± 20.02ï¼½%, P < 0.05), while the percentage of IMS was higher in the former than in the latter group (ï¼»74.19 ± 26.84ï¼½% vs ï¼»59.92 ± 24.85ï¼½%, P < 0.05). The SAA level in the young infertility patients was correlated positively with the percentage of IMS (r = 0.170, P < 0.01), but negatively with sperm concentration (r = －0.227, P < 0.01) and the percentage of PMS (r = －0.468, P < 0.01). CONCLUSIONS: The stress biomarker salivary alpha amylase level in infertile young men is negatively correlated with semen quality, and therefore semen parameters can be improved by reducing the stress level.

[Dual mediating effects of positive and negative emotions on fertility stress and fertility quality of life among infertile men in China].

Objective: To explore the effects of fertility stress on the quality of life (QOL) of infertile men and the dual mediating roles of positive and negative emotions in fertility stress and fertility QOL. METHODS: Using the Fertility Problem Inventory, Fertility Quality of Life Questionnaire and Positive and Negative Affect Scale, we conducted a cross-sectional survey among 304 infertile men. We established a structural equation model for analysis of the relationship between the four variables of fertility stress, fertility QOL, positive emotion and negative emotion. RESULTS: The scores of the patients in fertility stress, fertility QOL, positive emotion and negative emotion were (158.42 ± 21.725), (60.72 ± 10.926), (32.15 ± 6.294) and (19.48 ± 6.378), respectively. The root mean square error approximation (RMSEA) of the direct effect model, positive emotion separate mediation model and negative emotion separate mediation model was >0.08, and the dual mediation model showed optimum fit indexes, with χ2 / df = 1.959, goodness of fit index (GFI) = 0.950, adjusted GFI (AGFI) = 0.919, normed fit index (NFI) = 0.899, incremental fit index (IFI) = 0.948, Tucker-Lewis index (TLI) = 0.926, comparative fit index (CFI) = 0.947, and RMSEA = 0.056. The results of bootstrap test indicated that the positive and negative emotions had significant mediating effects, both incomplete, on fertility stress and fertility QOL. Moreover, the separate mediation of positive emotion exhibited no statistically significant difference from that of negative emotion (95% CI: －0.063 to 0.028). CONCLUSIONS: Positive emotion and negative emotions are part of the intermediary in fertility stress and fertility QOL. Fertility stress can affect fertility QOL through the dual mediating effect of positive emotion and negative emotions in infertile men.

Stress increases the risk of pregnancy failure in couples undergoing IVF.

Stress plays an important role in reproductive health and likely is one of the psychological factors affecting ART success. This study was designed to examine the relationship between the stress level as inferred from the amount of the enzyme alpha-amylase secreted in saliva (SAA) and pregnancy outcome in infertile couples undergoing in vitro fertilization and embryo transplantation (IVF-ET). A prospective cohort study was conducted in the Reproductive Medicine Centre of Zhengzhou University Hospital in Henan, China. Four hundred fifty-seven infertile couples undergoing in vitro fertilization and embryo transplantation (IVF-ET) for the first time participated in the study. Couples collected saliva samples the morning before the start of their first treatment cycle for the measurement of SAA. We found that the level of SAA (and hence, the amount of stress) in female partners, male partners, and couples analyzed together significantly affected IVF-ET outcome. Cutoff levels of SAA that predicted pregnancy failure were 136 µmol/L, 149 µmol/L, and 288 µmol/L in female partners, male partners, and couples, respectively. Female partners, male partners, and couples with high SAA levels had increased risk of pregnancy failure compared to those with low SAA levels. The SAA level directly correlated with the follicle-stimulating hormone level and was inversely proportional to the anti-Müllerian hormone level and endometrial thickness. Some semen parameters of male partners, such as density, survival rate, sperm rapid progressive motility (A%), and progressive motility [(A + B)%], were significantly lower in the high-SAA than in the low-SAA group. Furthermore, couples in the high SAA group had fewer transferable and high-quality embryos. We concluded that a high SAA level, known to be an objective indicator of high stress, increases the risk of pregnancy failure in infertile couples undergoing IVF-ET. Lay summary To explore the relationship between stress, as measured by the levels of the stress biomarker salivary alpha-amylase (SAA), and pregnancy outcome in infertile couples undergoing in vitro fertilization, a prospective cohort study was conducted in the Reproductive Medicine Centre of Zhengzhou University Hospital in Henan, China. Four hundred fifty-seven infertile couples undergoing IVF-ET collected saliva samples the morning before the start of their first treatment cycle for the measurement of SAA. Results of this study demonstrated that a high SAA level, known to be an objective indicator of high stress, increases the risk of pregnancy failure in infertile couples undergoing IVF-ET.

Psychological stress is related to a decrease of serum anti-müllerian hormone level in infertile women.

BACKGROUND: Stress exposure has been proved to be linked to reproductive failure. The reproductive potential of women depends on the ovarian reserve. Anti-müllerian hormone (AMH) has been proved a reliable clinical marker of ovarian reserve. However, the correlation between psychological stress and AMH level is not clear. METHODS: A cross-sectional study including 576 women was conducted. AMH concentration was tested to reflect the ovarian reserve. Salivary alpha-amylase (SAA) level was measured to assess the stress of patients objectively. RESULTS: The SAA level was significantly, and negatively correlated with AMH levels in infertile women (r = -0.315, P = 0.000; adjusted for age, r = -0.336, P = 0.000). CONCLUSION: Higher psychological stress was related to a decreased AMH level in infertile women and psychological stress may affect ovarian reserve.

Comparative study of pregnancy outcomes between day 3 embryo transfer and day 5 blastocyst transfer in patients with progesterone elevation.

OBJECTIVE: To explore the effects of progesterone (P) elevation on pregnancy outcomes of day 3 embryo and day 5 blastocyst transfer. METHODS: Clinical outcomes (pregnancy and ectopic pregnancy rates) following day 3 embryo and day 5 blastocyst transfer cycles were retrospectively analysed. Day 3 embryo and day 5 blastocyst transfer cycles were divided into normal P level (P ≤ 1.5 ng/ml) and P elevation group (P > 1.5 ng/ml), based on the serum P level on the day of human chorionic gonadotropin (hCG) administration. RESULTS: A total of 2868 cycles were analysed. In day 3 embryo transfer cycles (n = 2345), the clinical pregnancy rate was significantly higher in the normal P level group compared with the P elevation group (55.4% versus 46.7%, respectively) and the ectopic pregnancy rate was significantly lower in the normal P level group compared with the P elevation group (2.8% versus 7.9%, respectively). In day 5 blastocyst transfer cycles (n = 523), there were no significant differences in the clinical pregnancy and ectopic pregnancy rates between the two groups, based on the P level. CONCLUSION: These preliminary findings suggest that day 5 blastocyst transfer should be adopted for patients with P elevation on the day of hCG administration.

Correlative analysis of social support with anxiety and depression in men undergoing in vitro fertilization embryo transfer for the first time.

OBJECTIVE: To explore the correlation between the level of social support and the extent of anxiety and depression in Chinese men undergoing in vitro fertilization embryo transfer (IVF-ET) for the first time, in order to provide a basis for male mental health counselling. METHODS: Self-administered questionnaires covering general health status, anxiety (self-rating anxiety scale), depression (self-rating depression scale) and social support (social support rating scale) were completed by men undergoing their first round of IVF-ET. RESULTS: A total of 502 completed questionnaires were considered valid and were analysed. The anxiety, depression and social support scores for men undergoing their first round of IVF-ET were significantly higher than those for Chinese normative data. Social support was inversely correlated with anxiety and depression. CONCLUSIONS: These findings suggest that health care professionals should provide specific psychological counselling to Chinese men undergoing their first round of IVF-ET, in order to improve their psychological health and to facilitate increased levels of social support.