title: Hormonal imbalances and psychological scars left behind in infertile men.
abstract: The effect of infertility on the psychological well-being of couples has  been the subject of increasing attention in recent years. The frustration of  couples of a relatively young age (ie, in their fourth decades) provokes not  only anxiety and depression but also negative effects on the relationships.  The objective of this study was to evaluate the effect of a diagnosis of male  infertility on anxiety and depression in the men themselves and in fertile  female spouses. The prospective cross-sectional study consisted of 264  participants, 72 males diagnosed with nonobstructive azoospermia (NOA) and  their fertile spouses and 60 fertile couples attending our university between  January 1, 2009, and April 30, 2010. The Beck Anxiety Inventory, Beck  Depression Inventory (BDI), and hormone levels were measured during initial  and follow-up visits. In NOA men, follicle-stimulating hormone and luteinizing  hormone were positively associated with anxiety, in contrast to testosterone,  which was inversely associated with anxiety. After the diagnosis of NOA,  producing no testicular sperm, the panic intensity among men increased  significantly, whereas their spouses exhibited less panic. By contrast,  fertile female partners of NOA men reported higher BDI scores after the  initial diagnosis of azoospermia, whereas their partners recorded higher  levels of depression after the absence of testicular sperm was discovered.  Insomnia was the most common complaint for both sexes after the diagnosis of  azoospermia. Hormonal abnormalities had a negative effect on the quality of  life. Physicians and clinicians should acknowledge the immense psychosocial  effect of the diagnosis of male infertility on both males and their fertile  female partners.
authors.affiliation: Andrology Unit, Fertility Center of CHA Gangnam Medical Center, CHA University, Seoul 135-080, Korea.
authors.forename: Chong Won
authors.initials: CW
authors.lastname: Bak
authors.forename: Hyun Ha
authors.initials: HH
authors.lastname: Seok
authors.forename: Seung-Hun
authors.initials: SH
authors.lastname: Song
authors.forename: Eun Sun
authors.initials: ES
authors.lastname: Kim
authors.forename: Young Sun
authors.initials: YS
authors.lastname: Her
authors.forename: Tae Ki
authors.initials: TK
authors.lastname: Yoon
mesh_terms: D000328:Adult; D001007:Anxiety / Q000097:blood / Q000209:etiology / Q000523:psychology; D053713:Azoospermia / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000523:psychology*; D016009:Chi-Square Distribution; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D003863:Depression / Q000097:blood / Q000209:etiology / Q000523:psychology; D005260:Female; D043373:Follicle Stimulating Hormone, Human / Q000097:blood; D006728:Hormones / Q000097:blood*; D006801:Humans; D007986:Luteinizing Hormone / Q000097:blood; D008297:Male; D008603:Mental Health; D015999:Multivariate Analysis; D011446:Prospective Studies; D012044:Regression Analysis; D056910:Republic of Korea; D018570:Risk Assessment; D012307:Risk Factors; D007319:Sleep Initiation and Maintenance Disorders / Q000097:blood / Q000209:etiology / Q000523:psychology; D018454:Spouses / Q000523:psychology*; D013315:Stress, Psychological / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D011795:Surveys and Questionnaires; D013739:Testosterone / Q000097:blood; D055815:Young Adult
chemical_list: D043373:Follicle Stimulating Hormone, Human; D006728:Hormones; D013739:Testosterone; D007986:Luteinizing Hormone