Perceived stress and semen quality

Katrine H. Lund, Anne Sofie D. Laursen, Therese K. Grønborg, Gunnar Toft, Bjarke H. Jacobsen, Tanran R. Wang, Amelia K. Wesselink, Elizabeth E. Hatch, Greg J. Sommer, Michael L. Eisenberg, Kenneth J. Rothman, Henrik T. Sørensen, Lauren A. Wise, Ellen M. Mikkelsen*

*Corresponding author for this work

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperJournal articleResearchpeer-review


BACKGROUND: Psychological stress is prevalent among reproductive-aged men. Assessment of semen quality for epidemiological studies is challenging as data collection is expensive and cumbersome, and studies evaluating the effect of perceived stress on semen quality are inconsistent.

OBJECTIVE: To examine the association between perceived stress and semen quality.

MATERIAL AND METHODS: We analyzed baseline data on 644 men (1,159 semen samples) from two prospective preconception cohort studies during 2015-2021: 592 in Pregnancy Study Online (PRESTO) and 52 in (SF). At study entry, men aged ≥21 years (PRESTO) and ≥18 years (SF) trying to conceive without fertility treatment completed a questionnaire on reproductive and medical history, socio-demographics, lifestyle, and the 10-item version of the Perceived Stress Scale (PSS; interquartile range [IQR] of scores: 0-40). After enrollment (median weeks: 2.1, IQR: 1.3-3.7), men were invited to perform in-home semen testing, twice with 7-10 days between tests, using the Trak Male Fertility Testing System. Semen quality was characterized by semen volume, sperm concentration, and total sperm count. We fit generalized estimating equation linear regression models to estimate the percent difference in mean log-transformed semen parameters by four PSS groups (<10, 10-14, 15-19, ≥20), adjusting for potential confounders.

RESULTS: The median PSS score and IQR was 15 (10-19), and 136 men (21.1%) had a PSS score ≥20. Comparing men with PSS scores ≥20 with <10, the adjusted percent difference was -2.7 (95% CI: -9.8; 5.0) for semen volume, 6.8 (95% CI: -10.9; 28.1) for sperm concentration, and 4.3 (95% CI: -13.8; 26.2) for total sperm count.

CONCLUSION: Our findings indicate that perceived stress is not materially associated with semen volume, sperm concentration, or total sperm count.

Original languageEnglish
Pages (from-to)45-53
Number of pages9
Publication statusPublished - Jan 2023


  • cross-sectional study
  • in-home semen testing
  • male fertility
  • perceived stress
  • preconception
  • semen quality
  • Sperm Motility
  • Sperm Count
  • Spermatozoa
  • Prospective Studies
  • Semen
  • Humans
  • Semen Analysis
  • Male
  • Pregnancy
  • Stress, Psychological
  • Female
  • Adult


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