The Relationship of Male Infertility with Somatosensory Amplification, Health Anxiety and Depression Levels

Prevalence of anxiety symptoms in infertile men: a systematic review and meta-analysis

BACKGROUND

Infertility in men causes problems in various aspects of their lives, including personal, family and social life. One of the most important of these problems is anxiety. Anxiety in infertile men can affect their health, quality of life, and response to treatment, highlighting the significance of anxiety in these men. Thus, this systematic review and meta-analysis was conducted to investigate the prevalence of anxiety symptoms in infertile men.

METHODS

To conduct this review study, two researchers independently searched international databases such as PubMed, Cochrane Library, Web of sciences, Scopus, PsyINFO, and the Google scholar search engine in English without considering any time limit until January 2, 2024. Keywords such as "anxiety," "infertility," "prevalence," and "epidemiology" were used, taking into account the specific search method of each database. Using the Newcastle-Ottawa Scale (NOS), the quality of the articles was evaluated by two researchers independently.

RESULTS

In the systematic part of the study, 27 studies were included, and given the variety of measurement tools (8 different tools) used to investigate anxiety symptoms in infertile men, 24 studies were analyzed in five subgroups of tools. The pooled prevalence of anxiety symptoms in infertile men was 21.37% (95% CI: 15.73-27.02). The lowest and highest prevalence of anxiety in infertile men were related to the Beck anxiety inventory (BAI) and Depression Anxiety Stress Scales (DASS), accounting for 7.08% (95% CI: 3.27-10.90) and 34.90% (95%CI: 28.90-40.90) values respectively. This prevalence was 19.80% (95%CI: 9.01-30.59) for the Hospital Anxiety and Depression Scale (HADS), 30.06% (95%CI: 18.59-41.52) for the Spielberger Trait Anxiety Inventory (STAI-T), and 18.52% (95%CI: 7.76-29.29) for the Self-Rating Anxiety Scale (SAS).

CONCLUSION

The results of this systematic review and meta-analysis indicated that the prevalence of anxiety symptoms in infertile men requires special attention to healthcare planning. The healthcare system of different countries should evaluate the symptoms of anxiety in infertile men and take appropriate measures to reduce them according to the culture of the countries. It is recommended that all infertile couples be assessed for anxiety symptoms using a standardized tool during their initial evaluation.

Exploring pathogenesis and biomarkers through establishment of a rat model of male infertility with liver depression and kidney deficiency

OBJECTIVES

To establish a rat model that accurately replicates the clinical characteristics of male infertility (MI) with Liver Depression and Kidney Deficiency (LD & KD) and investigate the pathogenesis.

METHODS

After subjecting the rats to chronic restraint stress (CRS) and adenine treatment, a series of tests were conducted, including ethological assessments, evaluations of reproductive characteristics, measurements of biochemical parameters, histopathological examinations, and analyses of urinary metabolites. Additionally, bioinformatics predictions were performed for comprehensive analysis.

RESULTS

Compared to the control, the model exhibited significant manifestations of MI with LD & KD, including reduced responsiveness, diminished frequency of capturing estrous female rats, and absence of mounting behavior. Additionally, the kidney coefficient increased markedly, while the coefficients of the testis and epididymis decreased significantly. Sperm counts and viabilities decreased notably, accompanied by an increase in sperm abnormalities. Dysregulation of reproductive hormone levels in the serum was observed, accompanied by an upregulation of proinflammatory cytokines expressions in the liver and kidney, as well as exacerbated oxidative stress in the penile corpus cavernosum and testis. The seminiferous tubules in the testis exhibited a loose arrangement, loss of germ cells, and infiltration of inflammatory cells. Furthermore, utilizing urinary metabolomics and bioinformatics analysis, 5 key biomarkers and 2 crucial targets most closely linked to MI were revealed.

CONCLUSION

The study successfully established a clinically relevant animal model of MI with LD & KD. It elucidates the pathogenesis of the condition, identifies key biomarkers and targets, and provides a robust scientific foundation for the prediction, diagnosis, and treatment of MI with LD & KD.

Effectiveness of mindful self-compassion therapy on psychopathology symptoms, psychological distress and life expectancy in infertile women treated with in vitro fertilization: a two-arm double-blind parallel randomized controlled trial

OBJECTIVES

Infertility is a prominent problem affecting millions of couples worldwide. Recently, there has been a hightened emphasis on elucidating the subtle linkages between infertility treatment leveraging assisted reproductive technology and the complex realm of psychological challenges, as well as efforts in implementation of psychological interventions.The Mindful Self-Compassion (MSC) program seeks to improve self-compassion, compassion for others, mindfulness, and life satisfaction while reducing depression, anxiety, and stress. In the current study, an MSC intervention was performed on infertile women (IW) undergoing in vitro fertilization (IVF) to assess the effectiveness of this intervention in reducing psychological distress and psychopathological symptoms and enhancing life expectancy.

METHODS

Fifty-seven IW undergoing IVF were randomly allocated to two groups: MSC (n = 29) or treatment as usual (TAU; n = 28). Participants in MSC met once a week for two hours for eight weeks and attended a half-day meditation retreat. The Synder's Hope questionnaire and the Revised 90-Symptom Checklist (SCL-90-R) were used as the primary outcome measures. Data were obtained before the intervention, immediately after the intervention, and two months post-intervention. Repeated measures of ANCOVA and paired t-tests in all assessment points were used to compare the MSC and the TAU groups in outcomes.

RESULTS

In the MSC group, hopelessness, anger-hostility, anxiety, interpersonal sensitivity difficulties, and depression were significantly reduced compared with the TAU group, and those improvements persisted at the two-month follow-up. Reliable change index revealed that the MSC group's gains were both clinically significant and durable.

CONCLUSIONS

MSC can facilitate higher life satisfaction and mental well-being for IW undergoing IVF by reducing psychological distress, psychopathological symptoms, and hopelessness. These encouraging findings call for more research into the effectiveness of mindfulness-based therapies in addressing psychological problems among IW undergoing IVF.

Prevalence of depression in infertile men: a systematic review and meta-analysis

BACKGROUND

Generally, infertile men hide their depression, which can threaten their health and lower their quality of life. Given the role of depression and its impact on people's health, this systematic review and meta-analysis aimed to investigate the prevalence of depression in infertile men.

METHODS

This research is a systematic review and meta-analysis based on preferred reporting items for systematic reviews and meta-analyses (PRISMA). Using the keywords of "Depression", "Emotional Depression", "Infertility", "Prevalence", and "Epidemiology", all English language articles were searched in international databases (PubMed, Cochran library, Web of sciences, Scopus, Embase, PsyINFO, and Google scholar) by two reviewers independently and without considering the time limit until September 2022. Title, abstract, full text and quality of each study were evaluated by two reviewers independently using the Newcastle-Ottawa Scale checklist. The results were analyzed using programming language and R software, and I2 test and Egger's Test were used to check heterogeneity and publication bias, respectively.

RESULTS

Twenty-two studies were included in the systematic part of this study; and 8 different measurement tools were used to identify depression. Then, based on the possibility of meta-analysis, 18 studies were included in 4 subgroups. Given the heterogeneity of the articles, random effect model was used. The overall prevalence of depression in infertile men was 18.30%. The lowest and highest overall prevalence of depression in men was reported to be 14.04% and 23.63% in the Zung Self-Rating Depression Scale (ZDS) and the Depression Anxiety Stress Scales (DASS) tools, respectively. The overall prevalence of depression among infertile men was reported to be 18.55% and 16.75% using the Beck Depression Inventory (BDI) and the Hospital Anxiety and Depression Scale (HADS) tools, respectively.

CONCLUSION

Based on the findings of this study, the significant prevalence of depression in infertile men requires a specific attention and planning. The study revealed varying degrees of depression among infertile men, emphasizing the importance of assessing their mental health, specifically in terms of depression, during infertility treatments as a hidden variable. It is strongly recommended to develop training programs for health service providers to effectively utilize diagnostic tools in this particular field.

Self-reported sleep quality and oligo/astheno/teratozoospermia among men attending an infertility clinic: a longitudinal study

OBJECTIVE

We aimed to examine the influence of sleep disturbances on the risk of oligo/astheno/teratozoospermia (OAT) in men attending an infertility clinic.

METHODS

We consecutively enrolled men attending an infertility clinic from July 2020 to June 2021. Semen parameters were obtained at initial presentation, and the Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale score, and the STOP-BANG Questionnair were completed to assess sleep quality. Embryo outcomes were evaluated after infertility treatment.

RESULTS

Of 466 men enrolled, 119 had OAT (OAT group) and 347 had normozoospermia (NS group). There were no differences between the two groups regarding Epworth Sleepiness Scale and STOP-BANG Questionnaire scores. The prevalence of poor sleep quality (Pittsburgh Sleep Quality Index score ≥ 5) in the OAT group was significantly higher than that in the NS group (42% vs. 29%, p = 0.009). A higher rate of poor subjective sleep quality was observed in the OAT group compared with the NS group (p = 0.005) and Pearson's correlations revealed a negative relationship between subjective sleep quality and semen quality. Logistic regression found that subjective sleep quality was independently associated with an increased risk of OAT (adjusted odds ratio = 0.610, p = 0.007).

CONCLUSIONS

Men with OAT attending an infertility clinic exhibited poor subjective sleep quality. Improving sleep disturbances may be a target intervention to reduce the risk of OAT. This possibility warrants further investigation.

Fertility intention and its affecting factors in China: A national cross-sectional survey

Introduction

Low fertility rate has become an inevitable problem globally. Although current policies have a certain effect on promoting fertility and raising the birth rate, the overall effect is not obvious to meet the need. Therefore, the exploration of fertility intention and its affecting factors is extremely significant.

Methods

This study collected demographic data and the intention of respondents to have a second children, which focused on the factors that could affect fertility issues. 11,031 respondents were divided into non-fertile group (n = 5062) and fertile group (n = 5969) according to whether they had children or not, and the fertility group (n = 5969) were divided into group with 1-2 children (n = 5293) and group with ≥3 children (n = 676) according to the number of children. Non-fertility respondents aged 26-40 (n = 1369) were divided to explore the factors affecting the second-children intention. Binary logistic regression analysis was used to determine the affecting factors.

Results

It was revealed that gender [Male: OR: 0.60, 95% CI: 0.54-0.68], age [26-40: OR: 16.0, 95% CI: 13.4-19.1; 41-60: OR: 233.8, 95% CI: 186.7-292.6; >60: OR: 105.6, 95% CI: 77.1-144.6], political status [Partisans: OR: 0.48, 95% CI: 0.42-0.54], highest educational level [Middle school: OR: 0.21, 95% CI: 0.17-0.26; College degree or above: OR: 0.09, 95% CI: 0.08-0.11], whether having chronic disease [Yes: OR: 1.95, 95% CI: 1.60-2.38] and depression [Mild depression: OR: 0.63, 95% CI: 0.56-0.72; Moderate depression: OR: 0.43, 95% CI: 0.36-0.53; Moderate to severe depression: OR: 0.45, 95% CI: 0.35-0.57; Severe depression: OR: 0.50, 95% CI: 0.33-0.74] were important factors affecting fertility intention. We found that age [26-40: OR: 0.11, 95% CI: 0.08-0.15; 41-60: OR: 0.15, 95% CI: 0.12-0.18; >60: 0.81, 95% CI: 0.66-0.99], region [Central China: OR: 1.49, 95% CI: 1.20-1.86; Western China: OR: 1.75, 95% CI: 1.41-2.18], resident place [Urban: OR: 0.59, 95% CI: 0.49-0.72], per capita monthly household income [6001-12000: OR: 0.63, 95% CI:0.46-0.83; ≥12,000: OR: 1.83, 95% CI: 1.20-2.80], political status [Non-partisans: OR: 0.24, 95% CI: 0.09-0.69], highest educational level [Middle school: OR: 0.36, 95%CI: 0.27-0.46; College degree or above: OR: 0.22, 95% CI: 0.17-0.30] and anxiety [Moderate anxiety: OR: 1.39, 95% CI: 1.04-1.88; Severe anxiety: OR: 2.19, 95% CI: 1.26-3.80] were the main affecting factors for choosing the number of children. Furthermore, the second-children intention investigation in respondents aged 26-40 showed that gender [Male: OR: 2.06, 95% CI: 1.67-2.53], resident place [Urban: OR: 0.59, 95% CI: 0.49-0.72], per capita monthly household income [≥12,000: OR: 1.86, 95% CI: 1.23-2.82] and pressure [Severe pressure: OR: 0.54, 95% CI: 0.34-0.85] were the important factors.

Conclusion

Region, educational level, psychological factors, income, political status and medical insurance were the important factors affecting the intention of fertility and the number of children. The government should take these factors into account when optimizing the existing policy.

The Relationship of Acne With Somatosensory Amplification, Health Anxiety, and Depression Levels

Objective The objective of this study is to evaluate the somatosensory amplification, as well as anxiety and depression levels in acne vulgaris (AV) patients, and to examine their relationship with disease severity. Methods Sociodemographic form, Global Acne Grading System (GAGS), Somatosensory Amplification Scale (SSAS), Health Anxiety Inventory (HAI), Beck Anxiety Inventory (BAI), and Beck Depression Inventory (BDI) were applied to the patient group. All scales, except GAGS, were also applied to the healthy controls. Results All psychiatric scale scores of acne patients were higher than those of the control group. Moreover, the patient group had significantly higher SSAS, BDI scores, HAI total scores, and subscales of hypersensitivity to somatic symptoms and anxiety compared to the healthy controls. A positive but weak correlation was found between all scale scores. In patients with AV, no correlation was found between acne severity, age, disease duration, and all scale scores. Conclusion A significant relationship was found between somatosensory amplification, depression, and health anxiety in acne patients, independent of global acne severity, age, and disease duration. More successful acne treatment and patient management will be possible with an interdisciplinary approach that includes both psychiatry and dermatology.

Evaluation of male sexual parameters in infertile couples with a history of abortion

INTRODUCTION

It is thought that both individuals are affected psychologically and sexually in couples experiencing abortion. In addition to the stress caused by infertility, sexual life may also be negatively affected in couples who experience psychogenic wear, such as abortion and curettage. The aim of this study is to evaluate male sexual functions in infertile couples with a history of abortion and male infertility component.

METHODS

Five hundred forty-seven male patients' data were evaluated retrospectively. Group 1 was the included the males of the couples without abortion history and the rest with abortion history was group 2. In addition to demographic data, abortion history, libido level, presence of morning erection and intercourse frequency were evaluated. Hormone levels of all patients were evaluated. After that we created sub-group 1 and sub-group 2 from these groups, respectively, due to whether the patients fulfilled the international index of erectile function (IIEF), Beck anxiety inventory (BAI) and Beck depression inventory (BDI).

RESULTS

There were not any significant differences between the groups regarding psychiatric scale scores, hormone levels, libido, intercourse frequency and IIEF scores. Only orgasmic dysfunction was significant in the males of the couples with abortion history.

CONCLUSION

Man is not affected from abortion process in which woman get involved. Men only have orgasmic dysfunction when there is one or more abortion history in couples.

Selective Serotonin Reuptake Inhibitor (SSRI) Use is Not Associated With Impaired Semen Parameters

OBJECTIVE

To examine the association between selective serotonin reuptake inhibitor (SSRI) use and semen quality.

METHODS

We performed a retrospective review of all men undergoing semen analysis (SA) for fertility evaluation from 2002-2020 at a single academic medical center. Men were excluded if they had prior exposure to spermatotoxic medications, clomiphene citrate, gonadotropins, selective estrogen receptor modulators, or medical conditions known to impact male fertility. SSRI exposure was defined by an outpatient prescription within 90 days prior to any semen test. Differences between men with and without SSRI exposure were assessed with Wilcoxon rank sum for continuous variables and chi-squared testing for proportions. Univariable and multivariable linear regression models were fit to evaluate the relationship between SSRI use and individual semen parameters, controlling for age at the time of the semen analysis and non-SSRI drug use.

RESULTS

A total of 8861 men were identified, of whom 153 men (1.7%) were exposed to SSRIs prior to SA. Median age was 35 years (interquartile range: 32-39) and was similar between groups (P = .999). Non-SSRI medication use was significantly higher in men taking SSRIs (78.4% vs 23.3%, < .001). On univariable and multivariable analyses, SSRI exposure was not associated with differences in semen volume, sperm concentration, motility, total motile sperm count, or normal morphology.

CONCLUSION

In adult men undergoing fertility evaluation, SSRI exposure was not associated with impaired semen parameters. These data may help inform reproductive counseling and medical decision-making regarding SSRI use in men seeking paternity.

Is female urge associated with incontinence, somatosensory amplification, health anxiety and depression?

PURPOSE

Incontinence is a condition that can cause significant problems that can affect patients' quality of social, emotional, psychological and sexual life. The aim of this study was to evaluate the level of anxiety, health anxiety, depression and somatosensory amplification in patients with urge incontinence.

MATERIALS AND METHODS

The study group consisted of 58 patients that met the inclusion criteria. The control group consisted of 67 volunteer participants that did not have physical or psychiatric illness and incontinence complaints. All participants filled out sociodemographic data form, Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Somatosensory Amplification Scale (SSAS) and Health Anxiety Inventory (HAI).

RESULTS

The mean duration of incontinence in patients with urge incontinence was 16.55 ± 10.03 months. The mean age in urge incontinence group and the control group were 40.98 ± 9.58 and 39.1 ± 7.89 years, respectively. The mean values of SSAS, HAI and BAI scores in the incontinence group were significantly higher than the control group (P < .001), but there was no significant difference between the groups in terms of BDI scores. The linear regression analysis indicated that HAI and BAI significantly affected SSAS (P = .025 and 0.019, respectively).

CONCLUSIONS

Anxiety, health anxiety and somatosensory amplification are more common in patients who report urge incontinence. For these reasons, we believe that psychiatric evaluation should be included in the diagnosis and treatment process of patients presenting with urgency and incontinence symptoms.

Associations between depression, oxidative stress, and semen quality among 1,000 healthy men screened as potential sperm donors

OBJECTIVE

To explore the association between depression and semen quality and the mediating role of oxidative stress.

DESIGN

Cross-sectional study with repeated measures of semen quality.

SETTING

Human Sperm Bank of Hubei Province, People's Republic of China.

PATIENT(S)

From April 2017 to July 2018, we recruited 1,000 potential sperm donors who completed the Beck Depression Inventory questionnaire and had measures of oxidative stress biomarkers.

INTERVENTION(S)

None.

MAIN OUTCOME MEASURE(S)

Severity of depression was evaluated by the Beck Depression Inventory scores (0-4, no depression; 5-13, mild depression; 14-20, moderate depression; and 21 or greater, severe depression). The urinary concentrations of 8-hydroxy-2-deoxyguanosine, 4-hydroxy-2-nonenal-mercapturic acid, and 8-iso-prostaglandin F_2α (8-isoPGF_2α) were measured to reflect oxidative stress status. Repeated semen quality parameters (n = 5,880) were examined by trained professional technicians according to the World Health Organization laboratory manual. Associations between depression, oxidative stress, and repeated measures of semen quality parameters were evaluated using linear or mixed-effects models with adjustment for potential confounders. Mediation analysis was performed to test the potential mediating role of oxidative stress.

RESULT(S)

A total of 391 (39.1%) men were classified as mild depression, 67 (6.7%) as moderate depression, and 19 (1.9%) as severe depression. Inverse dose-response relationships between severity of depression and semen quality parameters were found. Compared with men without depression (n = 523), those with severe depression had a 25.26% (95% confidence interval, -38.65%, -8.93%) lower semen volume, 37.04% (-55.37%, -11.20%) lower total sperm count, 13.57% (-23.17%, -2.78%) lower total motility, and 15.08% (-25.09%, -3.72%) lower progressive motility; men with moderate depression also had a 12.28% (-21.16%, -2.40%) lower semen volume and 23.56% (-36.50%, -7.97%) lower total sperm count. We found a positive dose-response relationship between severity of depression and urinary 8-isoPGF_2α concentrations. However, we found no evidence that the associations between depression status and semen quality were mediated by oxidative stress markers.

CONCLUSION(S)

In the study of Chinese male sperm donors, men with depression had worse semen quality parameters, including semen volume, sperm concentration, total sperm count, total motility, and progressive motility. Although depression was positively associated with urinary 8-isoPGF_2α concentrations, depression-semen quality associations were not mediated by oxidative stress.

Can Annual Daylight Cycles and Seasons Have an Effect on Male Sexual Functions?

Introduction Mammals' sexual functions exhibit seasonal variations that have been attributed to changes in the daylight. In this study, taking into consideration endocrine and psychogenic status, we aimed to investigate whether human males experience changes in erectile functions and sexual desire depending on daylight periods and seasons, and whether periodicity exists in human sexual behavior. Materials and methods International Index of Erectile Function (IIEF) and psychiatric scale scores of 221 male patients were evaluated. In addition, hormonal parameters of the patients were examined. These data were first evaluated in two groups (summer and winter) according to local daylight amounts the participants received. Then IIEF scores were also analyzed according to four conventional seasons (winter, spring, summer, and autumn). Results There was no significant difference in laboratory data, psychiatric scale scores and IIEF evaluations between summer and winter groups. Moreover, no significant difference was found in terms of sexual desire and erectile functions in terms of four seasons (p > 0.05). Conclusion According to the results of this study, there is no periodicity in human sexual functions both in relation to daylight and four seasons.

The relationship between major dietary patterns and fertility status in iranian men: a case-control study

In this case-control study, we aimed to investigate the association between major dietary patterns and fertility status in Iranian men. The study population included 400 newly diagnosed infertile men and 537 healthy individuals without a history of infertility in Yazd, Iran. Infertility was confirmed clinically, based on the World Health Organization (WHO) criteria. Dietary intake was assessed using a 168-item semi-quantitative food frequency questionnaire (FFQ), and dietary patterns were determined based on a principal component analysis. Four major dietary patterns were found in this study, including healthy, Western, mixed, and traditional dietary patterns. After adjustments for potential confounders, men above the median of a healthy dietary pattern showed a reduced risk of infertility compared to those below the median (OR 0.52; 95% CI 0.33-0.83). In contrast, men with greater adherence to Western and mixed dietary patterns were more likely to be infertile (OR 2.66; 95% CI 1.70-4.17 and OR 2.82; 95% CI 1.75-4.56, respectively). Also, there was no significant association between the traditional dietary pattern and the odds of infertility. The present study suggests that greater adherence to a healthy dietary pattern may have an inverse association with the odds of infertility; however, Western and mixed dietary patterns may be associated with an increased risk of infertility.

Prevalence and associated factors of erectile dysfunction, psychological disorders, and sexual performance in primary vs. secondary infertility men

BACKGROUND

Many infertile couples might experience erectile dysfunction (ED) and significant changes in the quality of sexual life and psychological state though information is limited in secondary infertile men in China. To determine whether primary or secondary infertility is associated with ED, psychological disorders, and sexual performance.

METHODS

This was a cross-sectional survey conducted at the Dongzhimen Hospital of Beijing University of Chinese Medicine (06/2019-01/2020). The participants completed a questionnaire including general information, sexual life, simplified International Index of Erectile Function (IIEF-5), Patient Health Questionnaire-9 (PHQ-9), and 7-item Generalized Anxiety Disorder Scale (GAD-7). Multivariable logistic regression was used to identify the factors associated with ED, depression, and anxiety.

RESULTS

ED was more frequent in secondary vs. primary infertility (46.5 % vs. 26.7 %, P < 0.001). Compared with men with primary infertility, those with secondary infertility showed lower IIEF-5 scores (P < 0.001), higher occurrence of TOIF (P = 0.001), had a higher awareness of partner's ovulation when having ED (P = 0.001), lower GAD-7 scores (P = 0.016), lower libido (P = 0.005), fewer intercourses per month (P = 0.001) and a lower sexual satisfaction score (P = 0.027). In the multivariate analysis, primary infertility was found to be an independent risk factor of anxiety (OR: 1.812, 95 %CI: 1.015-3.236). Some overlap is observed in factors associated with ED, psychological disorders, and sexual performance between primary and secondary infertility, but some factors are distinct.

CONCLUSIONS

The prevalence of ED in secondary infertility men was higher than that of primary infertility men, and the quality of sexual life was decreased. Primary infertility is an independent risk factor of anxiety.