@article{2b2c3b7dc3d345cbbf8e7fdbdadd2eb5,
title = "Biomarkers of Stress and Male Fertility",
abstract = "To study if stress, as measured by salivary alpha-amylase and cortisol, negatively impacts male fertility, as measured by semen parameters, pregnancy, and live birth rates. Prospective, cohort study of men enrolled in the Males, Antioxidants, and Infertility (MOXI) trial. One-hundred twelve infertile men provided first-morning salivary and semen samples at baseline. Salivary samples were analyzed for alpha-amylase and cortisol. Couples attempted to conceive naturally (months 1–3) and with clomiphene citrate/intrauterine insemination (months 4–6). The association between stress-related biomarkers and semen parameters including DNA fragmentation was assessed using linear regression models adjusting for male age. Salivary levels were dichotomized at the 80th percentile. Pregnancy/live birth rates in couples in the upper quintile were compared to remaining subjects using chi-square testing. Salivary levels of alpha-amylase were not associated with semen parameters or DNA fragmentation. Salivary cortisol levels were not correlated with DNA fragmentation or normal morphology. For every 1-unit increase in salivary cortisol, total sperm count increased by 13.9 million (95% CI: 2.5, 25.3) and total motile sperm count increased by 9.9 million (95% CI: 3.2–16.6). Couple pregnancy rates and live birth rates did not differ for males in the highest quintile of alpha-amylase (27% and 28%, p = 0.96; 23% and 21%, p = 0.87) or cortisol (40% and 26%, p = 0.22; 35% and 19%, p = 0.12), compared to males with lower values. Physiologic measures of high stress may not harm but actually improve semen parameters among men with male-factor infertility.",
keywords = "Amylase, Cortisol, Male infertility, Semen parameters",
author = "Spitzer, {Trimble L.} and Trussell, {J. C.} and Coward, {R. Matthew} and Hansen, {Karl R.} and Barnhart, {Kurt T.} and Cedars, {Marcelle I.} and Diamond, {Michael P.} and Krawetz, {Stephen A.} and Fangbai Sun and Heping Zhang and Nanette Santoro and Steiner, {Anne Z.}",
note = "Funding Information: The authors would like to acknowledge the important contributions of Esther Eisenberg, MD, towards the design and conduct of this study. This work was supported by National Institutes of Health (NIH)/Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) R25 HD075737, U10HD077844, U10HD077680, U10 HD077841, U10HD027049, U10HD038992, U10HD039005, and U10HD055925. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NICHD or NIH, nor does it necessarily reflect the official policy or position of the Department of the Navy, Department of Defense, or the US government. Funding Information: TLS reports no conflict of interests and is a military service member. This work was prepared as part of her official duties. Title 17 USC 105 provides that “Copyright protection under this title is not available for any work of the United States Government.” Title 17 USC 101 defines a US government work as a work prepared by a military service member or employee of the US government as part of that person{\textquoteright}s official duties. HZ reports grants from NIH during the conduct of the study. JCT, RMC, KTB, MIC, FS, and NS report no conflict of interests/disclosures. MPD reports grants from NIH/NICHD and NIH/NICHD Yale subcontract during the conduct of the study, is on the board of directors and stockholder in Advanced Reproductive Care, and has grants from AbbVie, ObsEva, and Bayer outside of submitted work. KRH reports grants from NIH/NICHD, Roche Diagnostics, and Ferring International PharmaScience Center USA, in addition to personal fees from AblaCare, outside of the submitted work. SAK reports grants from NICHD during the conduct of the study, personal fees from EIC Systems Biology in Reproductive Medicine, grant from Merck, and book royalties from Springer Publishing Co. AZS reports support from Prima-Temp and Seikagaku Corporation outside the submitted work. Funding Information: The authors would like to acknowledge the important contributions of Esther Eisenberg, MD, towards the design and conduct of this study. This work was supported by National Institutes of Health (NIH)/Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) R25 HD075737, U10HD077844, U10HD077680, U10 HD077841, U10HD027049, U10HD038992, U10HD039005, and U10HD055925. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NICHD or NIH, nor does it necessarily reflect the official policy or position of the Department of the Navy, Department of Defense, or the US government. Publisher Copyright: {\textcopyright} 2022, This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply.",
year = "2022",
month = apr,
doi = "10.1007/s43032-022-00853-x",
language = "English (US)",
volume = "29",
pages = "1262--1270",
journal = "Reproductive Sciences",
issn = "1933-7191",
publisher = "SAGE Publications Inc.",
number = "4",
}