Psychological stress and semen quality impairment: A systematic review

The aim of this review was to evaluate the extent to which psychological stress may adversely affect seminal quality parameters in men.

A systematic review was conducted across databases including Embase, PubMed, Scopus, and Web of Science. Studies were subjected to data extraction, risk of bias, and narrative synthesis.

A total of 34 studies were included in this review. Three (8.82%) studies were judged to be at a high risk of bias. Included studies were published between 1988 and 2023 and concerned a total of 11,141 participants, ranging from 20 to 1,362 participants per study. Psychological stress negatively impacted semen volume in 12.9% of studies, sperm concentration in 52.9%, total sperm count in 56.3%, sperm motility in 63.3%, and sperm morphology in 21.4%. Sources of psychological stress such as academic stress, daily life stress, infertility-related stress, stressful life events, and work-related stress were correlated to impairment of semen parameters in 70.6% of included studies. The ability to draw robust conclusions is severely restricted by significant heterogeneity across the reviewed literature.

This systematic review found that psychological stress is frequently associated with impaired semen parameters, particularly sperm concentration and sperm motility. Nevertheless, these findings should be interpreted with caution. Most of the reported associations are observational and do not establish a definitive causal relationship between psychological stress and semen quality impairment.