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Psychological stress and reproductive aging among pre-menopausal women
Human Reproduction, 07/06/2012
Clinical Article
Bleil ME et al. – Psychological stress was related to higher AFC among younger women and greater AFC decline across women, suggesting that greater stress may enhance reproductive readiness in the short term at the cost of accelerating reproductive aging in the long term. Findings are preliminary, however, due to the cross–sectional nature of the current study.
Methods- In a multi–ethnic, community sample of 979 participants [ages 25–45 (mean (standard deviation) = 35.2 (5.5)); 27.5% Caucasian] in the Ovarian Aging study, an investigation of the correlates of reproductive aging, the interaction of age–x–stress was assessed in relation to AFC to determine whether AFC and AFC loss varied across women experiencing differing levels of stress.
- Stress was assessed by the perceived stress scale and AFC was assessed by summing the total number of antral follicles visible by transvaginal ultrasound.
- In linear regression examining AFC as the dependent variable, covariates (race/ethnicity, socio–economic status, menarcheal age, hormone–containing medication for birth control, parity, cigarette smoking, bodymass index, waist–to–hip ratio) and age were entered on step 1, stress on step 2 and the interaction term (age–x–stress) on step 3.
- On step 3, significant main effects showed that older age was related to lower AFC (b = –0.882, P = 0.000) and greater stress was related to higher AFC (b = 0.545, P = 0.005).
- Follow–up analyses showed that the main effect of stress on AFC was present in the younger women only.
- A significant interaction term (b = –0.036, P = 0.031) showed the relationship between age and AFC varied as function of stress.
- When the sample was divided into tertiles of stress, the average follicle loss was –0.781, –0.842 and –0.994 follicles/year in the low–, mid– and high–stress groups, respectively
