a Reproductive Medicine Centre , The First Affiliated Hospital of the Zhengzhou University , Zhengzhou , China.
Stress. 2019 Jul;22(4):414-420. doi: 10.1080/10253890.2019.1584181. Epub 2019 Apr 26.
Stress plays an important role in reproductive health and likely is one of the psychological factors affecting ART success. This study was designed to examine the relationship between the stress level as inferred from the amount of the enzyme alpha-amylase secreted in saliva (SAA) and pregnancy outcome in infertile couples undergoing in vitro fertilization and embryo transplantation (IVF-ET). A prospective cohort study was conducted in the Reproductive Medicine Centre of Zhengzhou University Hospital in Henan, China. Four hundred fifty-seven infertile couples undergoing in vitro fertilization and embryo transplantation (IVF-ET) for the first time participated in the study. Couples collected saliva samples the morning before the start of their first treatment cycle for the measurement of SAA. We found that the level of SAA (and hence, the amount of stress) in female partners, male partners, and couples analyzed together significantly affected IVF-ET outcome. Cutoff levels of SAA that predicted pregnancy failure were 136 μmol/L, 149 μmol/L, and 288 μmol/L in female partners, male partners, and couples, respectively. Female partners, male partners, and couples with high SAA levels had increased risk of pregnancy failure compared to those with low SAA levels. The SAA level directly correlated with the follicle-stimulating hormone level and was inversely proportional to the anti-Müllerian hormone level and endometrial thickness. Some semen parameters of male partners, such as density, survival rate, sperm rapid progressive motility (A%), and progressive motility [(A + B)%], were significantly lower in the high-SAA than in the low-SAA group. Furthermore, couples in the high SAA group had fewer transferable and high-quality embryos. We concluded that a high SAA level, known to be an objective indicator of high stress, increases the risk of pregnancy failure in infertile couples undergoing IVF-ET. Lay summary To explore the relationship between stress, as measured by the levels of the stress biomarker salivary alpha-amylase (SAA), and pregnancy outcome in infertile couples undergoing in vitro fertilization, a prospective cohort study was conducted in the Reproductive Medicine Centre of Zhengzhou University Hospital in Henan, China. Four hundred fifty-seven infertile couples undergoing IVF-ET collected saliva samples the morning before the start of their first treatment cycle for the measurement of SAA. Results of this study demonstrated that a high SAA level, known to be an objective indicator of high stress, increases the risk of pregnancy failure in infertile couples undergoing IVF-ET.
压力在生殖健康中起着重要作用，可能是影响辅助生殖技术（ART）成功的心理因素之一。本研究旨在探讨从唾液中分泌的酶α-淀粉酶（SAA）量推断出的压力水平与不孕夫妇接受体外受精和胚胎移植（IVF-ET）的妊娠结局之间的关系。在中国河南郑州大学附属医院生殖医学中心进行了一项前瞻性队列研究。457 对首次接受体外受精和胚胎移植（IVF-ET）的不孕夫妇参与了这项研究。夫妇们在第一次治疗周期开始前的早晨采集唾液样本，用于测量 SAA。我们发现，女性伴侣、男性伴侣和夫妇共同分析的 SAA 水平（因此，压力量）显著影响 IVF-ET 结局。预测妊娠失败的 SAA 截断值分别为女性伴侣 136μmol/L、男性伴侣 149μmol/L 和夫妇 288μmol/L。与 SAA 水平低的夫妇相比，SAA 水平高的女性伴侣、男性伴侣和夫妇妊娠失败的风险增加。SAA 水平与卵泡刺激素水平直接相关，与抗苗勒氏管激素水平和子宫内膜厚度成反比。一些男性伴侣的精液参数，如密度、存活率、精子快速直线运动（A%）和前向运动[(A+B)%]，在 SAA 高的组中显著低于 SAA 低的组。此外，SAA 水平高的夫妇可移植和高质量胚胎数量较少。我们得出结论，高 SAA 水平（已知是高压力的客观指标）会增加不孕夫妇接受 IVF-ET 妊娠失败的风险。
