Document Type : Scientific Review
Author
1
Department of Obstetrics and Gynecology, School of Medicine, Kerman University of Medical Sciences, Kerman, Islamic Republic of Iran
2
Afzalipour Clinical Center for Infertility, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Islamic Republic of Iran
Abstract
Background: Psychological stress is common among individuals with infertility or undergoing treatment, but its relationship with reproductive outcomes remains uncertain, with heterogeneous human findings and complementary animal evidence on possible mechanisms.
Objective: This review synthesized human and animal evidence on psychological stress and reproductive outcomes, focusing on ART outcomes, gamete/embryo parameters, reproductive endocrine pathways, dyadic/psychosocial effects, and psychological interventions.
Methods: PubMed/MEDLINE, Scopus, and Web of Science were searched from inception to September 5, 2026, for human studies examining psychological, perceived, infertility-related, or physiological stress, plus relevant reviews and meta-analyses, alongside animal studies on stress and reproductive, gamete, embryo, endocrine, or fertility outcomes. Given heterogeneity, findings were synthesized narratively, with human and animal evidence analyzed separately.
Results: Human evidence showed no consistent association between female stress and definitive ART outcomes (pregnancy, embryo-related outcomes), though some stage-specific associations during IVF emerged. In men, stress was linked to adverse semen/sperm parameters, potentially via oxidative and neuroendocrine pathways. Dyadic stress affected relationship functioning, coping, and treatment persistence. Interventions generally improved stress, anxiety, depression, and coping, but effects on reproductive outcomes were inconsistent. Animal studies showed stress can alter ovarian function, folliculogenesis, oocyte competence, uterine function, implantation, spermatogenesis, and endocrine regulation.
Conclusions: Human evidence does not support a simple causal link between stress and ART success; associations vary by sex, timing, stress measurement, endpoint, and study design. Animal models support biological plausibility but cannot establish human causality. Interventions consistently benefit well-being, while reproductive effects remain uncertain.
Keywords
Journal of Integrated Maternal and Pediatric Care