Table 6.

Adrenal-related fertility studies.

Authors (reference)	Type of study	Study design	Aim	Results	Conclusion
Csemiczky et al. (189)	in vivo human female	Comparative study	Assessment of prolactin and cortisol levels as well as assessment of the personality profile of infertile women	Infertile women also had significantly higher levels of prolactin and cortisol throughout their menstrual cycle	Infertile women have higher serum cortisol and anxiety levels
Smeenk et al. (190)	in vivo human female	Multicenter study	Evaluation of the relationships between the concentrations of stress hormones in the urine: adrenaline, noradrenaline and cortisol in women entering IVF for the first time	A significantly higher concentration of the assessed hormones was found before IVF, which decreased in the case of IVF success	Cortisol is the missing link in the relationship between psychosocial stress and outcome after IVF/ICSI
Piquer et al. (191)	in vivo animal (rat) female	Animal medical experiment	Determination of changes in the expression of the placental norepinephrine transporter during pregnancy and their relationship with its ability to transport norepinephrine under stress conditions	Exposure of pregnant rats to sympathetic stress resulted in increased levels of norepinephrine and corticosterone throughout pregnancy, decreased placental capacity to clear fetal norepinephrine into the maternal circulation, altered levels of placental epinephrine transporter protein depending on fetal sex, and increased placental and offspring body weight	Increased placental adrenaline transporter levels in pregnancy have been associated with decreased adult fertility of offspring
Kapoor et al. (192)	in vivo animal (guinea pigs) female	Animal medical experiment	Assessment of the impact of prenatal stress on the function of the hypothalamic-pituitary-adrenal (HPA) axis in adult offspring	The concentration of cortisol in the offspring of mothers exposed to stress was significantly higher than in the control	Stress exerted on the pregnant female during neuroendocrine development programs growth, HPA axis function and stress-related behavior in adult male guinea pigs
Mayerhofer et al. (193)	in vivo animal (hamster) male	Animal medical experiment	Evaluation of the effect of catecholamines on androgen production during periods of gonadal activity and rest in a seasonally reproducing species	Catecholamines have been shown to modulate the Leydig cell response to gonadotropins in this species of hamster	Stress hormones have a negative impact on reproductive functions and abilities
Rehman et al. (194)	in vivo human male	Retrospective study	Comparing the concentration of stress markers and antioxidants in fertile and infertile men and examining their impact on reproductive hormones and fertility	Cortisol, epinephrine, follicle-stimulating hormone and luteinizing superoxide dismutase, glutathione levels were significantly higher in the group of patients compared to the control group	Stress together with the reduction of antioxidant concentration plays an important role in reducing the reproductive potential in infertile men