Observing the Effects of Anxiety Levels on Male Reproductive Parameters

De Jager, Terri-Ann Lenice (2019-12)

Thesis (MMed)--Stellenbosch University, 2019.

Thesis

ENGLISH ABSTRACT: Literature presents a complex and often contradictory picture of the link between psychological stress and male fertility. Very limited information is available on the specific relationship between anxiety level and male fecundity. University students, when compared to the general population, exhibit signs of decreased mental health, with students having increased prevalence of depression, anxiety, psychosis and addictions. The aim of the study was to determine if there is a relationship between anxiety and reproductive parameters in a male student model and what that relationship is. Twenty-one male participants between the ages of 20 and 25 were recruited as a part of this study. Participants were asked to donate at 4 different time-points. At each time-point, a semen sample and blood sample were collected and a State Trait Anxiety Inventory questionnaire was filled in. A semen analysis, presented in a spermiogram report, was performed using computer-aided sperm analysis to gather information about the basic semen parameters e.g. sperm concentration, sperm motility and sperm kinematics. The percentage fragmented sperm DNA, sperm nitric oxide level and semen reactive oxygen species levels were investigated. The cytokine profile and cortisol level were investigated in both the seminal plasma and blood plasma. The student population observed in this study displayed increased anxiety levels when considering their state (39.0, SD=13.69, n=83) and trait (43.0, SD=12.55, n=83) anxiety scores, respectively. Blood plasma cortisol levels were noted to increase as state and trait scores increased. Cortisol was thought to have an overall immuno-suppressant effect both locally, in the reproductive tract, as well as systemically. Round cells were positively correlated to blood plasma cortisol levels and trait anxiety levels. Throughout the study it was observed that average path velocity (VAP) and straight-line index (STR) kinematic parameters decreased as state anxiety scores, trait anxiety scores and blood plasma cortisol levels increased. An inverse relationship between total motility and trait anxiety was observed. The inverse relationship observed between elevated blood plasma cortisol and decreased spermatozoa viability and spermatozoa motility parameters is possibly a function of the increased number of round cells observed during this study. These findings suggest a possible role for increased anxiety or psychological stress to elucidate idiopathic infertility by means of affecting the cytokine profile. The increase in number of round cells in this study could therefore be a result of increased release of immature germ cells from a compromised blood-testis barrier. The changes in the cytokine profile, round cells in the semen and sperm motility often correspond to values observed in men presenting with idiopathic infertility. It can be concluded from this study that an increase in anxiety levels were found to have a negative relationship with male reproductive parameters.

AFRIKAANSE OPSOMMING: Die literatuur bied 'n komplekse en dikwels teenstrydige prentjie van die verhouding tussen sielkundige stres en manlike vrugbaarheid. Beperkte inligting is tans beskikbaar oor die spesifieke verband tussen angsvlak en manlike fekunditeit. In vergelyking met die algemene bevolking toon universiteitstudente tekens van verminderde geestesgesondheid, wat die voorkoms van depressie, angs, psigose en verslawing verhoog. Die doel van die studie was om vas te stel óf daar 'n verband bestaan tussen angs en voortplantingsparameters in 'n manlike studentemodel, en wat hierdie verband is. Een-en-twintig manlike deelnemers tussen die ouderdomme van 20 en 25 is as deel van hierdie studie gewerf. Deelnemers is gevra om een semenmonster en een bloedmonster op 4 verskillende tydpunte te skenk. By elke tydpunt was 'n staats-trek angs inventaris (STAI) vraelys ingevul. 'n Semenalise, aangebied in spermiogram formaat is uitgevoer met behulp van rekenaargesteunde semenanalise om inligting oor die basiese semenparameters in te samel, bv. konsentrasie, motiliteit en spermkinematika. Die persentasie sperme met gefragmenteerde DNA, sperm stikstofoksiedvlakke en semen reaktiewe suurstofspesies vlakke is ondersoek. Die sitokienprofiel en kortisolvlak is in beide die seminale plasma en bloedplasma ondersoek. Die studentepopulasie wat in hierdie studie ondersoek is, het verhoogde angsvlakke met betrekking tot beide hulle staat-angs (“state”) (39.0, SD = 13.69, n = 83) en trek-angs (“trait”) (43.0, SD = 12.55, n = 83) tellings, getoon. Daar is opgemerk dat bloedplasma-kortisolvlakke toeneem namate die staat-angs (“state”) en trek-angs (“trait”) tellings verhoog. Daar word vermoed dat kortisol 'n algehele immuunonderdrukkende effek het, beide plaaslik, in die voortplantingskanaal, sowel as sistemies. Ronde sel voorkoms het positief gekorreleer met bloedplasma-kortisolvlakke en trek-angs (“trait”) telling. Gedurende die studie is daar waargeneem dat die kinematiese parameters naamlik, gemiddelde pad snelheid (VAP) en reguit-lyn-indeks (STR), afneem soos die staat-angs (“state”) en trek-angs (“trait”) tellings, sowel as bloedkortisolvlakke, verhoog. 'n Omgekeerde verband is waargeneem tussen totale spermmotiliteit en trek-angs (“trait”) telling. Die omgekeerde verband wat waargeneem is tussen verhoogde bloedplasma-kortisol en verminderde sperm lewensvatbaarheid en spermmotiliteit parameters is moontlik 'n funksie van die toenemende aantal ronde selle wat tydens hierdie studie waargeneem is. Hierdie bevindinge dui op 'n moontlike rol vir verhoogde angs of sielkundige spanning om idiopatiese onvrugbaarheid toe te lig deur die sitokienprofiel te beïnvloed. Die toename in die aantal ronde selle in hierdie studie kan dus die gevolg wees van 'n verhoogde vrystelling van onvolwasse kiemselle van 'n beskadigde bloed-testis-skans. Die veranderinge in die sitokienprofiel, ronde selle in die semen en spermmotiliteit stem dikwels ooreen met waardes wat waargeneem word by mans met idiopatiese onvrugbaarheid. Ten slotte, in hierdie studie is dit waargeneem dat 'n toename in angsvlakke 'n negatiewe verwantskap met manlike voortplantingsparameters gehad het.

Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/107203
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