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Volume 16, Issue 4 (July 2014) 16, 597–601; 10.4103/1008-682X.125404

Decline of semen quality during IVF is not associated with subjective male stress

Kazem Nouri1, Brigitte Litschauer2, Michael Sator1, Denise Tiringer1, Johannes Ott1, Katherina Walch1, Lukas A. Hefler3 and Clemens B. Tempfer4

1Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna 1090, Austria,
2Department of Clinical Pharmacology, Medical University Vienna, Vienna 1090, Austria,
3Department of Obstetrics and Gynecology, Krankenhaus Barmherzige Schwestern, Linz 4020, Austria
4Department of Obstetrics and Gynecology, Ruhr University Bochum, Bochum 44625 Germany

Correspondence: Dr. CB Tempfer (clemens.tempfer@marienhospital‑herne.de)

Received: 30 September 2013; Revised: 15 November 2013; Accepted: 09 December 2013


The aim of the present study was to find out 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 4-6 weeks before the start of IVF (T1) and at the day of oocyte retrieval (T2) was the primary outcome. Live birth rate (LBR), 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 pregnancy outcome.

Keywords: in vitro fertilization; questionnaire; semen quality; stress

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