P-566 Is the seminal oxidative stress the mirror of psychological stress perceived by infertile men?
Authors: Kooli R , Bousabbeh M , Sallem A , Chebil D , Haouas Z , Mehdi M 
Published: June 2023

Abstract

Study question
To assess the association between anxiety and depression scores and the levels of oxidative stress in seminal plasma of Tunisian infertile men.

Summary answer
Depression in hypofertile men is associated to higher levels of catalase in seminal plasma and thus to oxidative stress.

What is known already
Within the last decades, the knowledge concerning the link between psychological and oxidative stress in infertile men has been surging. In a limited number of studies aiming to elucidate the psychological aspect of male infertility, data related to increased incidence of depression and anxiety have been reported. It has also been reported that anxiety and depression may trigger the production of reactive free oxygen radicals leading to disruption of the balance between free radicals and antioxidants semen properties.

Study design, size, duration
This was a cross-sectional study performed in the Laboratory of Cytogenetics and Reproductive Biology of Fattouma Bourguiba University Teaching Hospital (Monastir Tunisia). A total of 282 patients were assessed for levels of anxiety and depression and evaluated for semen parameters. Among these, 105 patients were assessed for levels of superoxide dismutase (SOD) and 51 patients were evaluated for the levels of catalase in seminal plasma from September 2022 to January 2023.

Participants/materials, setting, methods
Were included patients addressed for semen quality assessment. All patients with a previously diagnosed psychological disorder, those who presented severe depression and/or anxiety symptoms or had a stressful life event were not included. Informed consent was obtained from all the participants. The subjects were evaluated for anxiety and depression symptoms using the valid Arab version of the HAD (Hospital Anxiety and Depression) scale. Semen analysis and results interpretation were performed according to 2021 WHO guidelines.

Main results and the role of chance
The mean HAD-D (depression) and HAD-A (anxiety) scores were of 6.56 ± 3.07 (IIQ [4-8]) and 7.94 ± 3.73 (IIQ [5-10]) respectively. The mean levels of SOD and catalase were of 42.32 ± 24.08 and 19599.82 ± 12745.36 respectively. The results showed that patients exhibiting elevated HAD-D scores have higher levels of catalase in seminal plasma compared to those with normally ranging HAD-D scores (29856.07±15904.51 VS 17968.14±11564.79 respectively; p= 0.02). However, SOD levels were similar between the two groups and no correlation was found between seminal oxidative stress as assessed by catalase and SOD levels and both HAD-D and HAD-A scores.

Limitations, reasons for caution
The main limitation reason could be related to the limited number of patients evaluated for levels of catalase in seminal plasma (N = 51). Furthermore, assessing hormone’s levels (LH, FSH and testosterone) would be of great interest in elucidating the implicated pathways leading to oxidative stress and impaired semen quality.

Wider implications of the findings
Our results shed the light on the elevated levels of the catalase in patients with high depression scores. The absence of correlation between antioxidant enzymes and psychological well-being of infertile patients is a reassuring finding. However, awareness and recognition of depressive symptoms in infertile men is crucial when managing infertility.

Trial registration number
not applicable