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General

Psychogenic Infertility and Stress

Chronic psychological stress activates the HPA axis, suppressing GnRH pulsatility and impairing ovulation and endometrial receptivity.

Overview

Overview

Chronic psychological stress activates the HPA axis, suppressing GnRH pulsatility and impairing ovulation and endometrial receptivity.

Symptoms

Anovulation despite otherwise normal investigations
Irregular cycles during high-stress periods
Anxiety and depression

Causes

1
Hypothalamic-pituitary-adrenal axis over-activation
2
Social and occupational stressors

How It's Diagnosed

Exclude organic cause first
Psychological screening (PHQ-9, GAD-7)
Cortisol AM level
Hormone panel

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