Interactions of stress and reproduction - a personal view.

In the first part of this article, the authors discuss the effect of stress upon reproduction. The paper begins with a discussion of the various stressful factors that influence the functions of reproductive organs under various circumstances, including menarche, gestation and lactation. In general, physical and emotional stress has a negative impact upon reproductive function. Chronic stress may delay pubescence and, during the reproductive years, may impair oogenesis and spermatogenesis. This process may result in transitory infertility in women and permanent sterility in men. If associated with pregnancy, stress may be conducive to spontaneous abortion or premature birth. The second part of the article deals with stressful stimuli attributable to the reproductive process, the problem of infertility, techniques of assisted reproduction, and the management of unwanted gestations including induced abortion, fetal reduction, spontaneous miscarriage as well as in utero fetal death. The stress generating effects of singleton and multiple pregnancies and births are also outlined in some detail. In the third part of this article discuss effect of stress upon the fetus directly or through the maternal organism.