• Stress infertility

Stress infertility

HEALTH OF WOMAN. 2017.3(119):28–36

Kosei N. V., Reheda S. I., Iarotska N. V., Gorokhova G. O.,
SI «Institute of Pediatrics, Obstetrics and Gynecology, NAMS of Ukraine», Kiev 

In order to optimize the treatment of the primary stress-induced infertility the authors evaluated the effectiveness of complex therapy aimed at correcting the mental and emotional state, and the secondary hyperprolactinemia in 72 patients aged 24 to 40 years old with reproductive plans (38 women from the main group and 34 – the comparison group). The control group consisted of 30 healthy women. Research of hormonal homeostasis of patients before treatment was showed a decrease in the average level of the pituitary hormones, low average concentrations of estradiol and progesterone, moderately elevated level of prolactin, and reduced indicators of endometrial thickness. The vast majority of women were in a heightened state of reactive and personal anxiety. All of study participants received anti-stress therapy (phenibut + mebicar). In addition, the main group on the background of anti-stress treatment received the drug Cyclodynon®, which has a mild dopaminergic action, contributing to inhibition of prolactin secretion and normalize the function of the hypothalamic-pituitary-ovarian system. Within 3 months after the start of a complex anti-stress therapy in both groups the level of reactive anxiety was reduced, and the level of personal anxiety was reduced a lesser extent. Dynamic control of hormones showed a significant decrease in the average concentrations of prolactin and increase of the synthesis of follicle-stimulating, luteinizing hormone, estradiol and progesterone in the blood serum of a group of women receiving Cyclodynon®. In that group also was observed a significantly reduction the average concentration of prolactin and increased endometrial thickness. In the comparison group, which applied only anti-stress therapy, a similar trend was observed, but the full normalization not happened. Within three years after treatment the pregnancy occurred in 32 (94.11%) women of the main group, and only 17 (50%) – of the comparison group. The conclusion of research results: the combination of anti-stress and dopaminergic therapies is very effective. Consequently, it is possible to recommend assignment dopaminergic phyto-drugs (in particular Cyclodynon®) on background of anti-stress therapy for patients with stress-induced infertility with a view to correction of psychosomatic disorders and improvement of clinical pregnancy rates.

Key words: stress, infertility, anxiety, Cyclodynon®.

REFERENCES

1. Parashchuk YuS, Kalinovska OI, Hryshchenko MH, Parashchuk VIu. 2014. Bezplidnist u shliubi: navch. posibnyk. Kharkiv, KhNMU:124.

2. Louis GM, Lum KJ, Sundaram R et al. 2011. Stress reduces conception probabilities across the fertile window: evidence in support of relaxation. Fertil Steril 95:2184–9. https://doi.org/10.1016/j.fertnstert.2010.06.078; PMid:20688324 PMCid:PMC2975045

3. Piekarski DJ, Zhao S, Jennings KJ et al. 2013. Gonadotropin-inhibitory hormone reduces sexual motivation but not lordosis behavior in female Syrian hamsters (Mesocricetus auratus). Hormones and Behavior 64:501–10. https://doi.org/10.1016/j.yhbeh.2013.06.006; PMid:23827890 PMCid:PMC3955721

4. Sanders R. «Blocking hormone could eliminate stress-induced infertility». Berkeley news online, Jan 12, 2015. Available from: http:// news.berkeley.edu/2015/01/12/blocking-hormone-couldeliminate-stress-induced-infertility/, last accessed Nov 15, 2016.

5. Sato Y, Suzuki N, Horita H et al. 1996. Effects of long-term psychological stress on sexual behavior and brain catecholamine levels. Journal of Andrology 17:83–90. PMid:8723430

6. Son YL, Ubuka T, Millar RP et al. 2012. Gonadotropin-inhibitory hormone inhibits GnRH-induced gonadotropin subunit gene transcriptions by inhibiting AC/cAMP/PKA-dependent ERK Pathway in L(beta)T2 cells. Endocrinology 153:2332–43. https://doi.org/10.1210/en.2011-1904; PMid:22374973

7. Anna C. Geraghty, Sandra E. Muroy, Sheng Zhao, et al. Knockdown of hypothalamic RFRP3 prevents chronic stress-induced infertility and embryo resorption. University of California. Berkeley, United States. Canadian Institute for Advanced Research, Canada.

8. Batarshev AV. 2005. Bazovyie psihologicheskie svoystva i samoopredelenie lichnosti: Prakticheskoe rukovodstvo po psihologicheskoy diagnostike. SPb, Izdatelstvo «Rech»:44–49.

9. Diagnostiki emotsionalno-nravstvennogo razvitiya. Red. i sost. IB Dermanova. SPb, Izdatelstvo «Rech». 2002:124-126.

10. Praktikum po psihologii sostoyaniy: Uchebnoe posobie. Pod red. prof. OA Prohorova. SPb, Izdatelstvo «Rech». 2004:121–122.

11. Sele G. 1960. Ocherki ob adaptatsionnom sindrome. M, Medgiz.

12. Morozov VN, Hadartsev AA. 2010. K sovremennoy traktovke mehanizmov stressa. VNMT. 1.

13. Paton A, Harley R, Harvey T. «Editorial». Vitex: A Newsletter for Lamiaceae & Verbenaceae Research 1 (2000), available from: http://www.kew.org/data/ vitex/jan00.pdf, last accessed 2016 Nov, 15.

14. Merz PG, Gorkow C, Schrodter A et al. 1996. The effects of a special Agnus castus extract (BP1095E1) on prolactin secretion in healthy male subjects. Exp Clin Endocrinol Diabetes 104;6:447–53. https://doi.org/10.1055/s-0029-1211483; PMid:9021345

15. Berger D, Schaffner W, Schrader E et al. 2000. Efficacy of Vitex agnus castus L. extract Ze 440 in patients with pre-menstrual syndrome (PMS). Arch Gynecol Obstet 264;3:150–3. https://doi.org/10.1007/s004040000123; PMid:11129515

16. Schellenberg R. 2001. Treatment for the premenstrual syndrome with agnus castus fruit extract: prospective, randomised, placebo controlled study. British Medical Journal 322;7279:134–7. https://doi.org/10.1136/bmj.322.7279.134; PMid:11159568 PMCid:PMC26589

17. Milewicz A, Gejdel E, Sworen H et al. 1993. Vitex agnus castus extract in the treatment of luteal phase defects due to latent hyperprolactinemia. Results of a randomized placebo-controlled double-blind study. Arzneimittelforschung 43;7:752–6. PMid:8369008

18. Dmitriyeva TB. Drozdov AZ. Kogan BM. 2004. Osnovnyye nespetsificheskiye sistemy. adaptiruyushchiye organizm k ostromu i khronicheskomu stressu. Psikhiatriya chrezvychaynykh situatsiy. Rukovodstvo. M:8–41.

19. Balabolkin MI. 1989. Endokrinologiya. M. Meditsina:416.

20. Vaks VV. 2001. Giperprolaktinemiya: prichiny. klinika. diagnostika i lecheniye. Consilium medicum. 3;11:516–525.

21. Dzeranova LK. Tabeyeva KI. Goncharov NP i dr. 2005. Makroprolaktinemiya. Problemy reproduktsii 11(2):60–65.

22. Colao A, di Sarno A, Pivonello R et al. 2002. Dopamine receptor agonists for treating prolactinomas. Expert Opin Investig Drugs 11;6:787–800. https://doi.org/10.1517/13543784.11.6.787; PMid:12036422

23. Delitala G. 1992. Hyperprolactinaemia: causes, biochemical diagnosis and tests of prolactin secretion. Clinical Endocrinology ed. by A. Grossman. Oxford:123–47.

24. Molitch ME. 2001. Disorders of prolactin secretion. Endocrinol Metab Clin North Am 30;3:585–610. https://doi.org/10.1016/S0889-8529(05)70203-6

25. Olukoga AO. 2002. Macroprolactinaemia is clinically important. J Clin Endocrinol Metab 87;10:4833–4. https://doi.org/10.1210/jc.2002-020936; PMid:12364483

26. Schlechte JA. 2002. Editoral: the macroprolactin problem. J Clin Endocrinol Metab 87;12:5408–9. https://doi.org/10.1210/jc.2002-021617; PMid:12466326

27. Toldy E, Zoltan L, Szabolcs I. 2003. Hyperprolactinemia. Endocrine 22;3:267–73. https://doi.org/10.1385/ENDO:22:3:267

28. Akmaev IG. 2003. Neyroimmunoendokrinologiya: istoki i perspektivyi razvitiya. Usp. fiziol. nauk. 34;4:4–15.

29. Shalyapina VG, Rakitskaya VV. 2003. Reaktivnost gipofizarno-adrenokortikalnoy sistemyi na stress u kryis s aktivnoy i passivnoy strategiyami povedeniya. Ros. fiziol. zhurn. im. I.M. Sechenova 89;5:585–590.

30. Aguilera G, Kiss A, Liu Y, Kamitakahara A. 2007. Stress 10;2:153–61. https://doi.org/10.1080/10253890701391192; PMid:17514584

31. Ben-Jonathan N, Liby K, McFarland M, Zinger M. 2002. Prolactin as an autocrine/paracrine growth factor in human cancer. Trends Endocrinol Metab 13;6:245–50. https://doi.org/10.1016/S1043-2760(02)00603-3

32. Hinuma S, Shintani Y, Fukusumi S et al. 2000. New neuropeptides containing carboxy-terminal RFamide and their receptor in mammals. Nat Cell Biol 2;10:703–8. https://doi.org/10.1038/35036326; PMid:11025660

33. Tsutsui K, Saigoh E, Ukena K et al. 2000. A novel avian hypothalamic peptide inhibiting gonadotropin release. Biochem Biophys Res Commun 275;2:661–7. https://doi.org/10.1006/bbrc.2000.3350; PMid:10964719

34. Yin H, Ukena K, Ubuka T, Tsutsui K. 2005. A novel G protein-coupled receptor for gonadotropininhibitory hormone in the Japanese quail (Coturnix japonica): identification, expression and binding activity. J Endocrinol 184;1:257–66. https://doi.org/10.1677/joe.1.05926; PMid:15642802

35. Serov VN, Zvenigorodskiy IN. 2003. Diagnostika ginekologicheskih zabolevaniy s kursom patologicheskoy anatomii. M, BINOM. Laboratoriya znaniy: 139.

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