The aim of the present study was to assess if semen quality declines during in vitro fertilization （IVF） and whether or not this phenomenon is triggered by chronic male stress. In order to test this hypothesis, we f...The aim of the present study was to assess if semen quality declines during in vitro fertilization （IVF） and whether or not this phenomenon is triggered by chronic male stress. In order to test this hypothesis, we first investigated a retrospective cohort of 155 male IVF patients （testing cohort）. Subsequently, we started a prospective cohort study in men undergoing their first IVF and assessed semen quality and subjective male chronic stress using a validated tool, i.e. the Fertility Problem Inventory （FPI） questionnaire. The association between stress and sperm quality decline measured 4-6weeks before the start of IVF （T1） and at the day of oocyte retrieval （T2） was the primary outcome. Live birth rate, first trimester abortion and rate of poor responders were secondary outcomes. In the testing cohort, mean progressive motility, but not mean sperm density significantly declined. There were 78/154 （51%） men who showed a decline in semen density and 50/154 （32%） men who showed a decline in progressive motility. In the validation cohort, progressive motility declined, whereas, sperm density increased from T1 to T2. Of 78 men, 27 men had increased stress （FPI-score 〉 146）. Sperm density and progressive motility were not significantly different in men with and without stress. However, in the presence of male stress, couples had a higher rate of poor responders, miscarriages and a lower rate of live births. Subjective stress is not associated with a decline in semen quality observed during IVF but may be associated with adverse ore^nancv outcome.展开更多
文摘目的·采用潜在剖面分析法探索辅助生殖技术(assisted reproductive technology,ART)治疗前不孕(育)症夫妻二元应对水平的潜在剖面,并探讨不同剖面间的差异及相关因素。方法·招募2023年9月至11月在上海交通大学医学院附属仁济医院生殖医学中心接受ART治疗的不孕(育)症初诊夫妇,应用一般资料问卷、生育压力量表(Fertility Problem Inventory,FPI)、二元应对评估工具(Dyadic Coping Inventory,DCI)、生育生活质量量表(Fertility Quality of Life Tool,FertiQoL量表)进行评估。采用潜在剖面分析探索不孕(育)症夫妻治疗前二元应对的剖面类型,比较不同剖面之间的一般特征,及FPI和FertiQoL量表得分;采用多元Logistic回归分析不同二元应对剖面的相关因素。结果·共纳入257对不孕(育)症夫妻,女性平均年龄(30.15±3.07)岁,男性平均年龄(31.82±3.82)岁,平均婚龄(3.75±2.16)年,平均不孕(2.90±1.92)年;男方导致不孕118对、女方导致不孕109对、男女共患不孕(育)症30对;男性DCI平均得分(128.25±19.15)分,女性(129.91±18.32)分。根据二元应对水平,257对夫妻可分为4个潜在剖面:共同积极组(153对,59.5%)、共同消极组(85对,33.1%)、男方积极组(12对,4.7%)及男方消极组(7对,2.7%);不同剖面不孕(育)症夫妻的年龄、FPI得分、FertiQoL量表得分、再婚比例间差异均具有统计学意义(均P<0.05)。多元Logistic回归分析结果显示,以共同积极组为参照,共同消极组的男方年龄更大(OR=1.122,95%CI 1.004~1.254,P=0.036)、男女双方FPI得分更高(男:OR=1.019,95%CI 1.003~1.035,P=0.018;女:OR=1.020,95%CI 1.004~1.036,P=0.015)、男方FertiQoL量表得分更低(OR=0.966,95%CI 0.937~0.996,P=0.029)。结论·接受ART治疗前不孕(育)症夫妻的二元应对水平可分为4个剖面类型;与共同积极应对夫妻相比,男性生育压力大、年龄大、感知的生育生活质量低,以及女性生育压力大均是夫妻共同消极应对的危险因素。
文摘The aim of the present study was to assess if semen quality declines during in vitro fertilization （IVF） and whether or not this phenomenon is triggered by chronic male stress. In order to test this hypothesis, we first investigated a retrospective cohort of 155 male IVF patients （testing cohort）. Subsequently, we started a prospective cohort study in men undergoing their first IVF and assessed semen quality and subjective male chronic stress using a validated tool, i.e. the Fertility Problem Inventory （FPI） questionnaire. The association between stress and sperm quality decline measured 4-6weeks before the start of IVF （T1） and at the day of oocyte retrieval （T2） was the primary outcome. Live birth rate, first trimester abortion and rate of poor responders were secondary outcomes. In the testing cohort, mean progressive motility, but not mean sperm density significantly declined. There were 78/154 （51%） men who showed a decline in semen density and 50/154 （32%） men who showed a decline in progressive motility. In the validation cohort, progressive motility declined, whereas, sperm density increased from T1 to T2. Of 78 men, 27 men had increased stress （FPI-score 〉 146）. Sperm density and progressive motility were not significantly different in men with and without stress. However, in the presence of male stress, couples had a higher rate of poor responders, miscarriages and a lower rate of live births. Subjective stress is not associated with a decline in semen quality observed during IVF but may be associated with adverse ore^nancv outcome.
