| Symptome associé : | | |
| Le stress diminue significativement la probabilité de conception, chaque jour durant la fenêtre de fécondité, probablement à travers le système médullaire sympathique.
Retard de conception- infertilité .. cacher .... voir plus ..
La définition standard de la stérilité implique habituellement l'absence de grossesse chez un couple engagé avec des rapports sexuels aléatoires sur une période de 12 mois.
Mais, avec des rapports sexuels en période fertile reconnue par l’observation de la glaire (rapports sexuels orientés par la connaissance de la période fertile), la grossesse est plus rapidement obtenue. Il a été démontré que, après 3 cycles avec des rapports en période fertile reconnue par l’observation de la glaire, 90 pour cent des femmes en couples de fertilité normale ont conçu un enfant.
Ces données suggèrent que la définition de la stérilité peut être modifiée (D'après T Hilgers, The NaProTechnology Revolution, page page 235, modifié): si le couple n'a pas conçu après 3 cycles de rapports sexuels axés sur la fertilité, il y a une forte suspicion d'un problème d'infertilité.
Il existe 2 types d'infertilité :
L'infertilité primaire se réfère à des couples qui n'ont pas conçu d'enfant.
L'infertilité secondaire se réfère à des couples qui ont conçu au moins une fois, mais qui n'y pas parviennent pas maintenant.
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| Paraclinique utilisée : | | |
| Alpha-amylase .. cacher .... voir plus ..
Les concentrations d'alpha-amylase mais non de cortisol sont négativement associées au taux de fécondité au premier cycle, après ajustement sur l’âge des couples, la fréquence des relations sexuelles et la consommation d’alcool. Une réduction significative de la probabilité de conception pendant la fenêtre fertile pendant le premier cycle de la grossesse a été observée chez les femmes dont les concentrations salivaires de l'alpha-amylase étaient dans les quartiles supérieures par rapport aux femmes dans les quartiles inférieurs (HPD -0,284, intervalle de 95% 0,540, -0,029).
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| Test d'ovulation .. cacher .... voir plus ..
... lire plus sur ce sujet .... | | Source: Littérature médicale, Niveau de preuve élevé |
| Référence : | | |
| Home ovulation tests and stress in women trying to conceive: a randomized controlled trial .. cacher .... voir plus ..
STUDY QUESTION Does the use of a digital home ovulation test have any effect on the level of stress in women seeking to conceive? SUMMARY ANSWER No difference was found in levels of stress between women using digital ovulation tests to time intercourse compared with women who were trying to conceive without any additional aids: in addition, their use did not negatively impact time to conception in users but may provide additional benefits, including an increased understanding of the menstrual cycle, reassurance and confidence in focusing conception attempts to the correct time in the cycle. WHAT IS KNOWN ALREADY It has been suggested that timing of intercourse in such a way that it coincides with ovulation by using ovulation tests can lead to emotional distress; however, no study has been conducted to investigate this hypothesis specifically, until now. STUDY DESIGN, SIZE AND DURATION The study was performed over two complete menstrual cycles as a prospective, randomized, controlled trial including quantitative and qualitative methods. The intervention (test) group were given digital ovulation tests to time intercourse to the most fertile time of the cycle and the control group were provided with the current National Institute for Health and Clinical Excellence guidelines for increasing the chances of conception (intercourse every 2–3 days) and asked not to use any additional methods to time when ovulation occurs. PARTICIPANTS/MATERIALS, SETTING AND METHODS A total of 210 women who were seeking to conceive were recruited from the general UK population. A total of 115 women were randomized to the test group and 95 to the control group through block randomization. The positive and negative affect schedule (PANAS) and the Perceived Stress Scale (PSS) were used to measure subjective stress levels, the Short-Form 12 health survey was used as a measure of general health and well-being and urine samples were measured for biochemical markers of stress including urinary cortisol. Qualitative data were collected in the form of a telephone interview upon study completion. MAIN RESULTS AND THE ROLE OF CHANCE There was no evidence for a difference either in total stress as measured using the PSS or in total positive or negative affect using the PANAS questionnaire between the test and control groups at any time point for the duration of the study. During cycle 1, for example, on Day 6, the difference in total stress score (test–control) was −0.62 [95% confidence interval (CI) −2.47 to 1.24] and on the day of the LH surge, it was 0.53 (95% CI −1.38 to 2.44). In addition, no correlation was observed between time trying to conceive and levels of stress, or between age and levels of stress, and no evidence was found to show that stress affected whether or not a pregnancy was achieved. There is also no evidence that the biochemistry measurements are related to whether a pregnancy was achieved or of a difference in biochemistry between the treatment groups. The use of digital ovulation tests did not negatively affect time to conception and with an adequately sized study, could potentially show improvement. To ensure that the results of this study were not affected by chance, we used a number of different methods for measuring stress, each of which had been independently validated. LIMITATIONS AND REASONS FOR CAUTION Randomization occurred before the start of the study because of the need to provide the ovulation tests in readiness for Day 6 of the first cycle. As a consequence, a number of women fell pregnant during this period (22 and 13 in the test and control groups, respectively). A further 15 women were either lost to follow-up or withdrew consent prior to study start. Pregnancy rate was higher overall in the test group, so to ensure that there were sufficient data from women who failed to become pregnant in the test group, we implemented an additional biased recruitment. This second cohort may have been different from the first, although no significant differences were observed between the two phases of recruitment for any of the information collected upon admission to the study. WIDER IMPLICATIONS OF THE FINDINGS Women who seek medical advice while trying to conceive should not be discouraged by health care professionals from using digital ovulation tests in order to time intercourse. The cohort of women recruited to this study initially had no evidence of infertility and were looking to conceive in a non-medical setting. A separate study to assess the impact of home ovulation tests in a subfertile population would be of interest and complementary to the present study. STUDY FUNDING/COMPETING INTERESTS This study was funded by SPD Swiss Precision Diagnostics, GmbH, manufacturer of Clearblue® pregnancy and ovulation tests. SPD Development Company Ltd is a wholly owned subsidiary of SPD Swiss Precision Diagnostics GmbH; together referred to as SPD. TRIAL REGISTRATION NUMBER NCT01084304 (www.clinicaltrials.gov).
... lire plus sur ce sujet .... | | Source: Littérature médicale, Niveau de preuve élevé | 
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| Chez les femmes en demande d’un traitement contre l’infertilité, l’âge jeune et l’infertilité féminine dans le couple, étaient associés à un impact sexuel accru, et par conséquent, à un risque potentiellement accru de dysfonctionnement sexuel.
The Sexual Impact of Infertility Among Women Seeking Fertility Care .. cacher .... voir plus ..
Introduction Infertility affects approximately 6.7 million women in the United States. Couples with infertility have significantly more anxiety, depression, and stress. This is compounded by the fact that almost 40% of couples undergoing assisted reproduction technology still cannot conceive, which can have an ongoing effect on quality of life, marital adjustment, and sexual impact. Aim To assess the sexual impact of infertility in women undergoing fertility treatment. Methods This study is a cross-sectional analysis of women in infertile couples seeking treatment at academic or private infertility clinics. Basic demographic information was collected. Respondents were surveyed regarding sexual impact and perception of their infertility etiology. Multivariate regression analyses were used to identify factors independently associated with increased sexual impact. Main Outcome Measure Sexual impact of perceived fertility diagnosis. Results In total, 809 women met the inclusion criteria, of whom 437 (54%) agreed to participate and 382 completed the sexual impact items. Most of the infertility was female factor only (58.8%), whereas 30.4% of infertility was a combination of male and female factors, 7.3% was male factor only, and 3.5% was unexplained infertility. In bivariate and multivariate analyses, women who perceived they had female factor only infertility reported greater sexual impact compared with woman with male factor infertility (P = .01). Respondents who were younger than 40 years experienced a significantly higher sexual impact than respondents older than 40 years (P < .01). When stratified by primary and secondary infertility, respondents with primary infertility overall reported higher sexual impact scores. Conclusion In women seeking fertility treatment, younger age and female factor infertility were associated with increased sexual impact and thus these women are potentially at higher risk of sexual dysfunction. Providers should consider the role young age and an infertility diagnosis plays in a women’s sexual well-being.
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| Stress Reduces Conception Probabilities across the Fertile Window: Evidence in Support of Relaxation .. cacher .... voir plus ..
Objective To assess salivary stress biomarkers (cortisol and alpha-amylase) and female fecundity. Design Prospective cohort design. Setting United Kingdom. Patients 274 women aged 18–40 years attempting pregnancy were followed until pregnant or for six menstrual cycles. Women collected basal saliva samples on day 6 of each cycle, and used fertility monitors to identify ovulation and pregnancy test kits for pregnancy detection. Main Outcome Measures Exposures included salivary cortisol (μg/dL) and alpha-amylase (U/mL) concentrations. Fecundity was measured by time-to-pregnancy and the probability of pregnancy during the fertile window as estimated from discrete-time survival and Bayesian modeling techniques, respectively. Results Alpha-amylase but not cortisol concentrations were negatively associated with fecundity in the first cycle (fecundity odds ratio = 0.85; 95% confidence interval 0.67, 1.09) after adjusting for couples’ ages, intercourse frequency, and alcohol consumption. Significant reductions in the probability of conception across the fertile window during the first cycle attempting pregnancy were observed for women whose salivary concentrations of alpha-amylase were in the upper quartiles in comparison to women in the lower quartiles (HPD −0.284; 95% interval −0.540, −0.029). Conclusions Stress significantly reduced the probability of conception each day during the fertile window, possibly exerting its effect through the sympathetic medullar pathway.
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