{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T08:47:23Z","timestamp":1764233243212,"version":"3.46.0"},"reference-count":35,"publisher":"The Endocrine Society","issue":"12","license":[{"start":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T00:00:00Z","timestamp":1762387200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"National Institutes of Health\/National Institute on Aging","award":["R01 AG053332"],"award-info":[{"award-number":["R01 AG053332"]}]},{"name":"University of California San Francisco Department of Obstetrics, Gynecology and Reproductive Sciences"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,11,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>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.<\/jats:p>","DOI":"10.1210\/endocr\/bqaf163","type":"journal-article","created":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T13:08:50Z","timestamp":1762434530000},"source":"Crossref","is-referenced-by-count":0,"title":["Telomere Length, Psychological Stress, and Infertility in Women of Advanced Reproductive Age"],"prefix":"10.1210","volume":"166","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8415-782X","authenticated-orcid":false,"given":"Xiaojie","family":"Zhou","sequence":"first","affiliation":[{"name":"Division of Reproductive Endocrinology and Infertility, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco , San Francisco, CA 94158 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dana L","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Biochemistry and Biophysics, University of California San Francisco , San Francisco, CA 94158 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jue","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Biochemistry and Biophysics, University of California San Francisco , San Francisco, CA 94158 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elena","family":"HogenEsch","sequence":"additional","affiliation":[{"name":"Division of Reproductive Endocrinology and Infertility, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco , San Francisco, CA 94158 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3682-6907","authenticated-orcid":false,"given":"Marcelle I","family":"Cedars","sequence":"additional","affiliation":[{"name":"Division of Reproductive Endocrinology and Infertility, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco , San Francisco, CA 94158 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"80","published-online":{"date-parts":[[2025,11,14]]},"reference":[{"issue":"201","key":"2025112703415838100_bqaf163-B1","first-page":"1","article-title":"Updated methodology to estimate overall and unintended pregnancy rates in the United States. National Center for Health Statistics","volume":"2","author":"Rossen","year":"2023","journal-title":"Vital Health Stat"},{"volume-title":"2020 Assisted Reproductive Technology Fertility Clinic and National Summary Report","year":"2022","author":"Centers for Disease Control and Prevention","key":"2025112703415838100_bqaf163-B2"},{"issue":"3","key":"2025112703415838100_bqaf163-B3","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1016\/j.fertnstert.2018.04.017","article-title":"Skewed X-chromosome inactivation and shorter telomeres associate with idiopathic premature ovarian insufficiency","volume":"110","author":"Miranda-Furtado","year":"2018","journal-title":"Fertil Steril"},{"issue":"1","key":"2025112703415838100_bqaf163-B4","first-page":"201","article-title":"Impaired telomere length and telomerase activity in peripheral blood leukocytes and granulosa cells in patients with biochemical primary ovarian insufficiency","volume":"32","author":"Xu","year":"2017","journal-title":"Hum Reprod"},{"issue":"1","key":"2025112703415838100_bqaf163-B5","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1097\/EDE.0000000000000017","article-title":"Leukocyte telomere length and age at menopause","volume":"25","author":"Gray","year":"2014","journal-title":"Epidemiology"},{"issue":"11","key":"2025112703415838100_bqaf163-B6","doi-asserted-by":"crossref","first-page":"1697","DOI":"10.1007\/s10815-015-0581-4","article-title":"Cell-free DNA and telomere length among women undergoing in vitro fertilization treatment","volume":"32","author":"Czamanski-Cohen","year":"2015","journal-title":"J Assist Reprod Genet"},{"issue":"1","key":"2025112703415838100_bqaf163-B7","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1016\/j.fertnstert.2020.07.005","article-title":"Telomere aberrations, including telomere loss, doublets, and extreme shortening, are increased in patients with infertility","volume":"115","author":"M\u2019Kacher","year":"2021","journal-title":"Fertil Steril"},{"issue":"4","key":"2025112703415838100_bqaf163-B8","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1080\/14647273.2019.1575988","article-title":"The effect of maternal body mass index (BMI) and telomere function on in vitro fertilization (IVF) outcome: a preliminary cohort study","volume":"23","author":"Weeg","year":"2020","journal-title":"Hum Fertil (Camb)"},{"issue":"4","key":"2025112703415838100_bqaf163-B9","doi-asserted-by":"crossref","first-page":"957","DOI":"10.1016\/j.fertnstert.2020.09.164","article-title":"Shorter telomere length of white blood cells is associated with higher rates of aneuploidy among infertile women undergoing in vitro fertilization","volume":"115","author":"Hanson","year":"2021","journal-title":"Fertil Steril"},{"issue":"1","key":"2025112703415838100_bqaf163-B10","doi-asserted-by":"crossref","first-page":"e0261591","DOI":"10.1371\/journal.pone.0261591","article-title":"Peripheral mitochondrial DNA, telomere length and DNA methylation as predictors of live birth in in vitro fertilization cycles","volume":"17","author":"Li Piani","year":"2022","journal-title":"PLoS One"},{"issue":"6265","key":"2025112703415838100_bqaf163-B11","doi-asserted-by":"crossref","first-page":"1193","DOI":"10.1126\/science.aab3389","article-title":"Human telomere biology: a contributory and interactive factor in aging, disease risks, and protection","volume":"350","author":"Blackburn","year":"2015","journal-title":"Science"},{"issue":"49","key":"2025112703415838100_bqaf163-B12","doi-asserted-by":"crossref","first-page":"17312","DOI":"10.1073\/pnas.0407162101","article-title":"Accelerated telomere shortening in response to life stress","volume":"101","author":"Epel","year":"2004","journal-title":"Proc Natl Acad Sci U S A"},{"key":"2025112703415838100_bqaf163-B13","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1016\/j.bbi.2016.02.002","article-title":"Perceived stress and telomere length: a systematic review, meta-analysis, and methodologic considerations for advancing the field","volume":"54","author":"Mathur","year":"2016","journal-title":"Brain Behav Immun"},{"issue":"1","key":"2025112703415838100_bqaf163-B14","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1016\/S0015-0282(16)48316-0","article-title":"Psychological evaluation and support in a program of in vitro fertilization and embryo transfer","volume":"43","author":"Freeman","year":"1985","journal-title":"Fertil Steril"},{"issue":"3","key":"2025112703415838100_bqaf163-B15","first-page":"556","article-title":"Cumulative live birth rates after one ART cycle including all subsequent frozen-thaw cycles in 1050 women: secondary outcome of an RCT comparing GnRH-antagonist and GnRH-agonist protocols","volume":"32","author":"Toftager","year":"2017","journal-title":"Hum Reprod"},{"issue":"4","key":"2025112703415838100_bqaf163-B16","doi-asserted-by":"crossref","first-page":"642","DOI":"10.1016\/j.fertnstert.2017.06.035","article-title":"Outcomes from a university-based low-cost in vitro fertilization program providing access to care for a low-resource socioculturally diverse urban community","volume":"108","author":"Herndon","year":"2017","journal-title":"Fertil Steril"},{"issue":"5","key":"2025112703415838100_bqaf163-B17","doi-asserted-by":"crossref","first-page":"826","DOI":"10.1016\/S0015-0282(98)00040-5","article-title":"Cessation of gonadotropin-releasing hormone agonist therapy combined with high-dose gonadotropin stimulation yields favorable pregnancy results in low responders","volume":"69","author":"Faber","year":"1998","journal-title":"Fertil Steril"},{"issue":"1","key":"2025112703415838100_bqaf163-B18","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1016\/j.fertnstert.2011.10.031","article-title":"A characterization of the relationship of ovarian reserve markers with age","volume":"97","author":"Rosen","year":"2012","journal-title":"Fertil Steril"},{"issue":"10","key":"2025112703415838100_bqaf163-B19","doi-asserted-by":"crossref","first-page":"e47","DOI":"10.1093\/nar\/30.10.e47","article-title":"Telomere measurement by quantitative PCR","volume":"30","author":"Cawthon","year":"2002","journal-title":"Nucleic Acids Res"},{"key":"2025112703415838100_bqaf163-B20","doi-asserted-by":"crossref","first-page":"5371050","DOI":"10.1155\/2016\/5371050","article-title":"Systematic and cell type-specific telomere length changes in subsets of lymphocytes","volume":"2016","author":"Lin","year":"2016","journal-title":"J Immunol Res"},{"issue":"6","key":"2025112703415838100_bqaf163-B21","doi-asserted-by":"crossref","first-page":"1766","DOI":"10.1016\/j.fertnstert.2014.02.046","article-title":"Comparability of antim\u00fcllerian hormone levels among commercially available immunoassays","volume":"101","author":"Su","year":"2014","journal-title":"Fertil Steril"},{"issue":"4","key":"2025112703415838100_bqaf163-B22","doi-asserted-by":"crossref","first-page":"385","DOI":"10.2307\/2136404","article-title":"A global measure of perceived stress","volume":"24","author":"Cohen","year":"1983","journal-title":"J Health Soc Behav"},{"issue":"3","key":"2025112703415838100_bqaf163-B23","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1177\/014662167700100306","article-title":"The CES-D scale: a self-report depression scale for research in the general population","volume":"1","author":"Radloff","year":"1977","journal-title":"Appl Psychol Meas"},{"issue":"1","key":"2025112703415838100_bqaf163-B24","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1016\/j.fertnstert.2023.11.001","article-title":"Sperm telomere length in male-factor infertility and reproduction","volume":"121","author":"Randell","year":"2024","journal-title":"Fertil Steril"},{"issue":"2","key":"2025112703415838100_bqaf163-B25","doi-asserted-by":"crossref","first-page":"425","DOI":"10.3390\/genes14020425","article-title":"Telomere length, a new biomarker of male (in)Fertility? A systematic review of the literature","volume":"14","author":"Fattet","year":"2023","journal-title":"Genes (Basel)"},{"issue":"5","key":"2025112703415838100_bqaf163-B26","doi-asserted-by":"crossref","first-page":"1206","DOI":"10.1093\/humrep\/dep007","article-title":"Telomere length and reproductive aging","volume":"24","author":"Hanna","year":"2009","journal-title":"Hum Reprod"},{"issue":"2","key":"2025112703415838100_bqaf163-B27","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1016\/j.maturitas.2015.07.009","article-title":"Telomere length and age-at-menopause in the US","volume":"82","author":"Shenassa","year":"2015","journal-title":"Maturitas"},{"issue":"1","key":"2025112703415838100_bqaf163-B28","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1016\/j.fertnstert.2019.08.089","article-title":"Cumulus cells have longer telomeres than leukocytes in reproductive-age women","volume":"113","author":"Lara-Molina","year":"2020","journal-title":"Fertil Steril"},{"issue":"1","key":"2025112703415838100_bqaf163-B29","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1016\/j.fertnstert.2022.03.021","article-title":"Antim\u00fcllerian hormone and leukocyte aging markers in the coronary artery risk development in young adults study","volume":"118","author":"Kim","year":"2022","journal-title":"Fertil Steril"},{"issue":"12","key":"2025112703415838100_bqaf163-B30","doi-asserted-by":"crossref","first-page":"3761","DOI":"10.18632\/aging.101670","article-title":"DNA methylation-based age prediction and telomere length in white blood cells and cumulus cells of infertile women with normal or poor response to ovarian stimulation","volume":"10","author":"Morin","year":"2018","journal-title":"Aging (Albany NY)"},{"issue":"1","key":"2025112703415838100_bqaf163-B31","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1007\/s10815-012-9904-x","article-title":"Relationship between psychological stress and reproductive outcome in women undergoing in vitro fertilization treatment: psychological and neurohormonal assessment","volume":"30","author":"An","year":"2013","journal-title":"J Assist Reprod Genet"},{"issue":"6","key":"2025112703415838100_bqaf163-B32","doi-asserted-by":"crossref","first-page":"1745","DOI":"10.1016\/j.fertnstert.2004.12.039","article-title":"Infertility-related stress in men and women predicts treatment outcome 1 year later","volume":"83","author":"Boivin","year":"2005","journal-title":"Fertil Steril"},{"issue":"2","key":"2025112703415838100_bqaf163-B33","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1016\/j.fertnstert.2012.05.023","article-title":"Psychological distress and in vitro fertilization outcome","volume":"98","author":"Pasch","year":"2012","journal-title":"Fertil Steril"},{"issue":"feb23 1","key":"2025112703415838100_bqaf163-B34","doi-asserted-by":"crossref","first-page":"d223","DOI":"10.1136\/bmj.d223","article-title":"Emotional distress in infertile women and failure of assisted reproductive technologies: meta-analysis of prospective psychosocial studies","volume":"342","author":"Boivin","year":"2011","journal-title":"BMJ"},{"volume-title":"How Does the Adult Kaiser Permanente Membership in Northern California Compare With the Larger Community?","year":"2006","author":"Gordon","key":"2025112703415838100_bqaf163-B35"}],"container-title":["Endocrinology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/endo\/advance-article-pdf\/doi\/10.1210\/endocr\/bqaf163\/65286886\/bqaf163.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/endo\/article-pdf\/166\/12\/bqaf163\/65286886\/bqaf163.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/endo\/article-pdf\/166\/12\/bqaf163\/65286886\/bqaf163.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T08:42:18Z","timestamp":1764232938000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/endo\/article\/doi\/10.1210\/endocr\/bqaf163\/8322701"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,6]]},"references-count":35,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2025,11,6]]}},"URL":"https:\/\/doi.org\/10.1210\/endocr\/bqaf163","relation":{},"ISSN":["1945-7170"],"issn-type":[{"type":"electronic","value":"1945-7170"}],"subject":[],"published-other":{"date-parts":[[2025,12]]},"published":{"date-parts":[[2025,11,6]]},"article-number":"bqaf163"}}