Association Between Stress Hormones and Sperm DNA Fragmentation in Men with Unexplained Infertility
Keywords:
Cortisol, DHEA, ACTH, DNA, fragmentation, Unexplained InfertilityAbstract
Background: Psychological and physiological stress has been an emerging interest as a likely contributor to male infertility by influencing endocrine regulation and sperm quality. Hormonal changes due to stress may induce a background of oxidative damage that could influence sperm DNA damage and thus affect fertility potential. Purpose: The purpose of this study was to explore the relationship between stress hormones and sperm DNA fragmentation in men with idiopathic infertility. Methods: A case–control study of 120 men aged 20–45. The subject group consisted of 60 men with unexplained infertility and 60 healthy fertile men as controls. Overnight fasting venous blood samples were taken for the measurement of serum cortisol (µg/dL), adrenocorticotropic hormone (ACTH; pg/mL) and dehydroepiandrosterone (DHEA; µg/dL) by enzyme-linked immunosorbent assay ELISA. Semen was collected from the infertile participants, who they were analyzed by using the staining method (Toluidin Blue TB). Results: Serum cortisol (20.84 ± 4.92 vs 16.73 ± 3.85 µg/dL; P = 0.004) and ACTH levels (42.61 ±8.34 vs 34-18±6-79 pg/mL; P =0-002) were significantly higher in the infertile men than healthy controls, respectively In contrast, levels of DHEA were significantly lower in infertile men than those of fertile ones (178.45 ± 38.72 vs. 221.36 ± 42.15 µg/dL; P =0.005). Cortisol (23.41 ± 4.83 vs. 18.47 ± 3.95 µg/dL; P = 0.006) and ACTH levels (46.28 ± 7.91 vs.39,15±6,84 pg/mL;P=0,007) were significantly elevated in men with damaged sperm DNA compared to those without impaired DNA integrity among infertile men. Conclusions: Unexplained infertile men have demonstrable evidence for stress-induced endocrine dysfunction characterized by elevated cortisol (and ACTH) levels combined with low DHEA concentrations.
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