Female Infertility Caused by Stress
Indhira Garcia
SUNY DOWNSTATE MEDICAL CENTERMIDWIFERY EDUCATION PROGRAM
NRMW 5401: RESEARCH I
Female Infertility caused by Stress
Infertility is the inability to conceive after one year of regular sexual contact without contraception. Pour (2014) estimates that 10 to 15 percent of couples of reproductive ages have this condition. This problem is caused by several factors, including men male factors (25 to 40%) and women female factors (49 to 55%). It is also accounted for by a combination of male and female factors (10%), as well as unknown causes (10%) (Pour, 2014). Between 1990 and 2006, 72.4 to 120.6 heterosexual women aged 20-40 and interested in having children were reported as being sterile in 25 different developed and developing countries (Pour, 2014). I’m not sure what this number represents actually. 72-120 women in this age group over more than a decade is actually a tiny number. This can’t be a percentage because it is way too high. Can you please explain 72.4 to 120.6 Several new methods of treatment are being developed for infertile couples due to advances in science, technology, and innovation, such as Intrauterine Injection (IUI), In Vitro Fertilization (IVF), IntraCytoplasmic Sperm Injection (ICSI), and others, but these treatments are more challenging and take longer (Pour, 2014). Actually, some of these have been developing for years and are quite successful these days. You should differentiate. Couples experiencing infertility face several problems such as miscommunication, problems with sexual activity, problems with decision-making, and emotional instability. A serious medical condition, infertility, affects the quality of life greatly. It has been reported that infertile women find infertility the most stressful time of their lives and that repeated and successive treatments are frequent periods of crisis (Bala et al., 2021). Infertility causes anxiety and depression in the psyche as it affects the psyche profoundly. Furthermore, infertility can last longer longer than what? This isn’t too clear as a result of such difficulties. Aside from adversely affecting physiological functions, anxiety can significantly affect fertility outcomes, and anxiety increases infertility. This vicious cycle further weakens couples’ reproductive capabilities. Additionally, women with high school diplomas or less face high levels of anxiety during infertility treatments due to lower success rates. CBT spell out has been shown to reduce the stress associated with infertility, a highly stressful medical condition. It has been suggested that using CBT during medical treatments can help manage psychological disorders. The program includes relaxation, cognitive restructuring, biofeedback, systematic desensitization, behavioral training, stop-thinking, and assertiveness training.
The Aim of the Research
A stress reduction technique identified as causing infertility in females is evaluated in this research paper. Indhira, reread this sentence. It looks like you are that stress reduction causes infertility. In many of these cross-sectional and interventional studies, female populations are recruited from clinics of reproductive medicine and kindred registries.
Literature Review on Stress and Infertility A complete literature review is Chapter 2, not Chapter 1. Did you look at the guidelines for Chapter 1. There is a clear outline with headings that you need to use for Chapter 1. Indhira, this is not really a literature review. It is a summary of the literature. In a literature review, you do a search for articles and then critique them and then draw conclusions based on how sound the research is, what biases it shows, what populations it has looked at and, most important, what gaps there are in the literature, that a study you are proposing can fill. See the next competency for Chapter 2. Studies have shown a reasonable correlation between women’s stress responses and fertility potential, resulting in literature accumulating studies that show contradictory results (Rooney & Domar, 2022). What does this mean? Is there a correlation or contradictory results? Additionally, there is converging evidence regarding the involvement of hormones in the female body-stress response.
The hypothalamic-pituitary-adrenal (HPA) system and the sympathetic-adrenal-medullary system (SAM) system are activated by stressful stimuli. In response to stressful stimuli, these hormones produce an abnormal, prolonged, and in some cases excessive body set-up, which can result in long-term changes in neuroendocrine function, which may affect female fertility. Adrenocorticotropic hormone (ACTH) is secreted by the anterior lobe of the pituitary gland through the adrenocorticotropic nucleus of the hypothalamus. As a result, ACTH is responsible for mediating the release of cortisol and glucocorticoids by the adrenal cortex.
Several physiological and mental consequences arise from the release of estrogen and cortisol by the adrenal cortex and medulla during a stress response, which makes the individual fight or flee from their stressor. Researchers have noted that individual differences in cortisol responses to ACTH may contribute to differences in the HPA axis function between individuals. They have concluded that this is due to differences in the transcription of genes and the functions of HPA molecules in the HPA axis. In the laboratory experiments performed on female cynomolgus monkeys who were subjected to mild combined psychological and metabolic stress, it was observed that the adrenal framework showed a selective and specific increase rather than a generalized increase, which is directly related to the problem of reproductive dysfunction resulting from stress (Sahraeian et al., 2018).
Sahraeian et al. (2018) stated that hypothalamic-pituitary-ovary (HPO) axis dysfunction occurs as a result of increased glucocorticoid release/concentrations. The bloodstream is saturated with high levels of glucocorticoids during distress, which affects the hypothalamus and alters the secretion of gonadotropin-releasing hormone (GnRH). It has also been demonstrated that glucocorticoids have an indirect effect on gonadotropin synthesis and release from the pituitary, even though glucocorticoids have also a direct effect on the pituitary (Sahraeian et al., 2018). Therefore, animal models have provided evidence in support of the hypothesis. By attenuating or blocking the expected rise in estrogens and luteinizing hormone (LH) in a sheep model, an injection of cortisol comparable to those produced in humans under stress delays follicular maturation and ovulation.
It is still unclear how this phenomenon takes place, as well as which signaling pathway it is triggered by, and this has been compounded further by the recent discovery of kisspeptin (KISS1) as well as gonadotropin-inhibitory hormone (GNIH) Golshani et al., 2021). Due to their sensitivity to high levels of glucocorticoids, these two neuropeptides have opposing effects on hypothalamic GnRH release. There is a stimulatory effect of KISS1 on the production of GnRH (Sahraeian et al., 2021). The administration of corticosterone reduced the expression of KISS1 in the hypothalamus during an estradiol-induced surge in LH and resulted in a decrease in KISS1 neuron activation in the mouse model. The activity of GnIH neurons is specifically inhibited by either GnRH molecules or KISS1 molecules (Golshani et al., 2021). A direct correlation has been demonstrated between acute and chronic stress in ewes and the inhibition of hypothalamic GnIH effects, including the inhibition of LH release from the pituitary gland Golshani et al., 2021).
Effects of Stress on Female Fertility
Ovulation, fertilization, and implantation, regardless of the origin of the stressful stimuli, can all be affected by stress on the female adrenal and HPO axis. Derivations in LH pulses induce or inhibit ovulatory function directly or indirectly by influencing ovarian steroid production. During the follicular and luteal phases of the ovarian cycle, work-induced stress can affect LH plasma levels directly (Golshani et al., 2021). It has been shown that distress in the general population, as well as in infertile women, leads to lower conception rates, longer menses (35 days), and lower fertility outcomes, including oocyte retrieval, fertilization, pregnancy, and live births (Golshani et al., 2021). Women with infertility who experience chronic psychosocial stress have also been found to have a reduced ovarian reserve. The presence of these markers was associated with a greater likelihood of a diminished ovarian reserve. Undernutrition and financial hardship, as well as low socioeconomic status, may negatively impact ovarian reserves.
Stress Reduction Technique that Causes Infertility
Investigating the effects of cognitive behavioral therapy-based counseling on stress levels could provide valuable information about potential interventions that could help reduce stress in this population.
The proposed stress reduction technique is cognitive-behavioral therapy-based counseling that will effectively reduce stress in women experiencing infertility. Golshani et al. (2021) provide evidence that cognitive behavioral therapy-based counseling is an effective intervention for reducing stress in pregnant women with a history of primary infertility. Golshani et al. (2021) investigated the relationship between anxiety and female infertility, a prevalent problem.
Cognitive behavioral interventions have been shown to reduce anxiety in research. Among infertile couples, CBT has been observed to reduce stress effectively. Several research studies have also shown that counseling and marital therapy relieve psychological problems in couples. Furthermore, Iranian researchers concluded that after CBT, infertile women’s anxiety during treatment is reduced (Golshani et al., 2020). Researchers have also shown that cognitive behavioral interventions may improve the mental health of infertile women. Further, it has been reported that CBT alone is not a reliable proposal for treating depression and anxiety in infertile women, but fluoxetine works better in treating the condition (Abdolahi et al., 2019). In life, one of the bitterest experiences is not being able to reproduce naturally and have a child. The social context can exacerbate that importance and cause the individual to have a mental health crisis. As a consequence, the current study examined whether CBT can be used to alleviate anxiety in women with infertility.
The Impact of Identified Stress Reduction Intervention on Female Infertility
Infertile women can reduce their anxiety with CBT. Infertile women report reduced anxiety and stress after cognitive behavioral intervention (Abdolahi et al., 2019). It has been shown that psychosocial support groups can influence the effectiveness of CBT to improve the mental health of infertile women (Sahraeian et al., 2019). Since infertile people can’t express their feelings at any point and know their problems are unique, the group provides the safest place for mental release and open discussion of untold issues.
CBT focuses on attitude, identifying, and restoring cognitive distortions, correct thinking skills, and evaluating judgments and negative thoughts, resulting in decreased anxiety, depression, and other psychological problems. As well as reducing mental health issues, promoting self-control impulses, emotions, and attitudes may be extremely beneficial for infertile women. A decrease in respiration rate and muscle relaxation leads to calm nerves and helps the individual control his muscles. This decrease in oxygen consumption, reduced carbon dioxide elimination, reduced heartbeat and blood pressure, reduced energy consumption, and reduced muscle contractions lead to a reduction in anxiety and stress. Conversely, students who get adequate feedback on their homework can apply their behavioral techniques in their daily lives.
Conclusion
To sum up, it may be said that pregnant women suffering from primary infertility may benefit from cognitive-behavioral counseling to improve their quality of life. If a woman cannot conceive after a year of regular sexual relationships without taking contraceptives, she is considered infertile. It appears that infertility can have a significant effect on the psyche, such as stress or depression as a result of developing anxiety and depression. This can increase the duration of infertility in turn, which is another important factor that puts you at risk. Due to anxiety factors, the physiological functioning of the body is restricted, and thus fertility outcomes are affected, but anxiety also contributes to the problem of infertility due to its effects. Therefore, a vicious cycle hampers couples’ capacity to have children by impairing their reproductive ability even more. Furthermore, women with high school graduates or less almost experience more anxiety during infertility treatments than other groups of women with low treatment success rates. Age-related changes in treatment success have caused a gradual increase in anxiety during treatment for infertile women. To decrease the stress associated with infertility and its treatment, many studies have been performed on cognitive-behavioral therapy (CBT) as an effective way to reduce the stress associated with infertility. To cope with psychological difficulties during medical treatment, cognitive behavior therapy is a method that uses relaxation, cognitive restructuring, biofeedback, desensitization, behavioral training, stop-thinking, and assertive training. Many researchers have suggested using cognitive behavior therapy to deal with psychological issues in medicine.
Indhira, I really cannot evaluate this paper since it does not at all follow the guidelines for Chapter 1, found in Competency 1. Also found in the grading rubric in the assignment. This reads like an undergraduate paper that summarizes a topic. It is not a research proposal. I’m not sure what to do. You did not submit a draft and this doesn’t fulfill the requirements for chapter 1. You cannot pass the course if you don’t have a grade for chapter 1—it is worth one/third of the course grade. Let’s talk. Please send me an email with some times that we can talk. Ronnie.
Reference
Abdolahi, H. M., Ghojazadeh, M., Abdi, S., Farhangi, M. A., Nikniaz, Z., & Nikniaz, L. (2019). Effect of cognitive behavioral therapy on anxiety and depression of infertile women: a meta-analysis. Asian Pacific Journal of Reproduction, 8(6), 251.
Bala, R., Singh, V., Rajender, S., & Singh, K. (2021). Environment, lifestyle, and female infertility. Reproductive sciences, 28(3), 617-638.
Golshani, F., Hasanpour, S., Mirghafourvand, M., & Esmaeilpour, K. (2021). Effect of cognitive behavioral therapy-based counseling on perceived stress in pregnant women with a history of primary infertility: A controlled randomized clinical trial. BMC Psychiatry, 21(1), 1–11.
Golshani, F., Mirghafourvand, M., Hasanpour, S., & Biarag, L. S. (2020). The effect of cognitive behavioral therapy on anxiety and depression in Iranian infertile women: a systematic and meta-analytical review. Iranian journal of psychiatry and behavioral sciences, 14(1).
Pour, T. H. (2014). The effect of cognitive behavioral therapy on anxiety in infertile women. European Journal of Experimental Biology, 4(1), 415-419.
Rooney, K. L., & Domar, A. D. (2022). The relationship between stress and infertility. Dialogues in clinical neuroscience.
Sahraeian, M., Lotfi, R., Qorbani, M., Faramarzi, M., Dinpajooh, F., & Ramezani Tehrani, F. (2019). The effect of Cognitive Behavioral Therapy on sexual function in infertile women: A randomized controlled clinical trial. Journal of sex & marital therapy, 45(7), 574-584.
