Telomere Length, Psychological Stress, and Infertility in Women of Advanced Reproductive Age

Abstract Preliminary studies suggest a link between shortened telomeres, infertility, and poorer in vitro fertilization (IVF) outcomes. Infertility patients often experience high levels of psychological stress during treatment. Whether there is a link between stress and telomere length in infertility patients has not previously been studied; thus our goal was to examine differences in telomere length in infertile vs noninfertile women and to determine if telomere length correlates with psychological stress and IVF laboratory outcomes. We conducted a case-control study comparing nulliparous women aged 35 to 42 years with unexplained infertility or diminished ovarian reserve undergoing IVF to noninfertile age-matched controls. Average telomere length was measured in peripheral blood mononuclear cells. Psychological stress was measured by the Perceived Stress Scale and the Center for Epidemiologic Studies Depression Scale. The infertile cases had significantly shorter telomeres than the fertile controls; stress did not account for this difference. Associations were observed between telomere length, ovarian reserve measures, and quantitative IVF outcomes independent of age, suggesting that telomere attrition in somatic cells may relate to the underlying pathophysiology of low ovarian reserve and fertility status.