Alpha casozepine and L-theanine in ameliorating stress levels in infertile couples: a review
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20230844Keywords:
Alpha-casozepine, Stress, , Infertility, L-theanine, HPA axis, Hypothalamic-pituitary-gonadal axisAbstract
Globally, the fertility rate has decreased significantly in the last two decades. Infertility can lead to psychological and emotional stress, particularly for couples who have been married for a long period. According to the literature, stress can alter the metabolic environment and reduce the likelihood of pregnancy. The fertility treatments involving assisted reproductive technology put additional physical, mental, and financial strain on patients, especially women who are frequently subjected to invasive procedures as part of the process. Stress affects the hypothalamic-pituitary-adrenal (HPA) axis, the concentration of reproductive hormones (FSH, GnRH, and LH), and other biological processes through a variety of mechanisms. Alteration of glucocorticoid hormone levels in the blood was observed because of stress in infertile couples. Moreover, the males also get affected by stress as per the semen parameters and quality analysis. Available evidence strongly suggests that stress reduction should be the first step in a fertility therapy regimen. Further, managing stress can boost ovarian function and semen parameters. The current review focuses on the state-of-the-art research on stress-induced reproductive dysfunction as well as the positive effects of alpha-casozepine, an anxiolytic-like bioactive decapeptide and L-theanine, an amino acid found primarily in green tea on reducing stress levels and improving treatment outcomes in infertile couples.
References
Mascarenhas MN, Flaxman SR, Boerma T, Vanderpoel S, Stevens GA. National, regional, and global trends in infertility prevalence since 1990: A systematic analysis of 277 Health Surveys. PLoS Med. 2012;9.
Infertility. World Health Organization. World Health Organization. Available at: https://www.who.int/health-topics/infertility#tab=tab. Accessed on 15 February 2023.
Wu AK, Elliott P, Katz PP, Smith JF. Time costs of Fertility Care: The hidden hardship of building a family. Fertility and Sterility. 2013;99:2025-30.
Gollenberg AL, Liu F, Brazil C, Drobnis EZ, Guzick D, Overstreet JW et al. Semen quality in fertile men in relation to psychosocial stress. Fertil Steril. 2010;93:1104-11.
Domar AD, Clapp D, Slawsby EA, Dusek J, Kessel B, Freizinger M. Impact of group psychological interventions on pregnancy rates in infertile women. Fertil Steril. 2000;73:805-11.
Zorn B, Auger J, Velikonja V, Kolbezen M, Meden-Vrtovec H. Psychological factors in male partners of infertile couples: Relationship with semen quality and early miscarriage. Int J Androl. 2008;31:557-64.
Nepomnaschy PA, Welch KB, McConnell DS, Low BS, Strassmann BI, England BG. Cortisol levels and very early pregnancy loss in humans. Proceedings National Academy Sci. 2006;103:3938-42.
Pfaus JG. Reviews: Pathways of sexual desire. J Sexual Med. 2009;6:1506-33.
Campagne DM. Should fertilization treatment start with reducing stress? Human Reproduct. 2006;21:1651-8.
Boivin J, Schmidt L. Infertility-related stress in men and women predicts treatment outcome 1 year later. Fertil Steril. 2005;83:1745-52.
De Liz TM, Strauss B. Differential efficacy of group and individual/couple psychotherapy with infertile patients. Human Reproduct. 2005;20:1324-32.
Hämmerli K, Znoj H, Barth J. The efficacy of psychological interventions for infertile patients: A meta-analysis examining mental health and pregnancy rate. Human Reproduct Update. 2009;15:279-95.
Gameiro S, Boivin J, Dancet E, de Klerk C, Emery M, Lewis-Jones C et al. Eshre guideline: Routine psychosocial care in infertility and medically assisted reproduction-A guide for fertility staff: Figure 1. Human Reproduct. 2015;30:2476–85.
Frederiksen Y, Farver-Vestergaard I, Skovgard NG, Ingerslev HJ, Zachariae R. Efficacy of psychosocial interventions for psychological and pregnancy outcomes in infertile women and men: A systematic review and meta-analysis. BMJ Open. 2015;5.
Dayas CV, Buller KM, Crane JW, Xu Y, Day TA. Stressor categorization: Acute physical and psychological stressors elicit distinctive recruitment patterns in the amygdala and in medullary noradrenergic cell groups. Euro J Neurosci. 2001;14:1143-52.
Smith R, Grossman A, Gaillard R, Clement-Jones Vicky, Ratter Sally, Mallinson J et al. Studies on circulating met-Enkephalin and β-endorphin: Normal subjects and patients with renal and adrenal disease. Clin Endocrinol. 1981;15:291-300.
Spencer SJ, Tilbrook A. The glucocorticoid contribution to obesity. Stress. 2011;14:233-46.
Papadimitriou A, Priftis KN. Regulation of the hypothalamic-pituitary-adrenal axis. Neuroimmunomodulation. 2009;16:265-71.
Sapolsky RM. Glucocorticoids and hippocampal atrophy in neuropsychiatric disorders. Arch General Psychiatr. 2000;57:925.
Krsmanovic LZ, Hu L, Leung P-K, Feng H, Catt KJ. The hypothalamic gnrh pulse generator: Multiple Regulatory Mechanisms. Trends Endocrinol Metabol. 2009;20:402-8.
Ohkura S, Uenoyama Y, Yamada S, Homma T, Takase K, Inoue N et al. Physiological role of metastin/kisspeptin in regulating gonadotropin-releasing hormone (GnRH) secretion in female rats. Peptides. 2009;30:49-56.
Vadakkadath Meethal S, Atwood CS. Alzheimer?s disease: The impact of age-related changes in reproductive hormones. CMLS Cellular Molecular Life Sci. 2005;62:257-70.
Papadimitriou A, Priftis KN. Regulation of the hypothalamic-pituitary-adrenal axis. Neuroimmunomodulation. 2009;16:265-71.
Tilbrook A. Effects of stress on reproduction in non-rodent mammals: The role of glucocorticoids and sex differences. Rev Reproduct. 2000;5:105-13.
Li XF, Bowe JE, Lightman SL, O’Byrne KT. Role of corticotropin-releasing factor receptor-2 in stress-induced suppression of pulsatile luteinizing hormone secretion in the rat. Endocrinology. 2005;146:318-22.
Li XF, Bowe JE, Kinsey-Jones JS, Brain SD, Lightman SL, O'Byrne KT. Differential role of corticotrophin-releasing factor receptor types 1 and 2 in stress-induced suppression of pulsatile luteinising hormone secretion in the female rat. Journal of Neuroendocrinology. 2006;18:602-10.
Li XF, Shao B, Lin CC, O'Byrne KT, Lin YS. Stress-induced inhibition of LH pulses in female rats: Role of GABA in arcuate nucleus. J Molecular Endocrinol. 2015;55:9-19.
Melis GB, Mais V, Gambacciani M, Paoletti AM, Antinori D, Fioretti P. Dexamethasone reduces the postcastration gonadotropin rise in women. J Clin Endocrinol Metabol. 1987;65:237-41.
Norman RL, Smith CJ. Restraint inhibits luteinizing hormone and testosterone secretion in intact male rhesus macaques: Effects of concurrent naloxone administration. Neuroendocrinology. 1992;55:405-15.
Bhongade MB, Prasad S, Jiloha RC, Ray PC, Mohapatra S, Koner BC. Effect of psychological stress on fertility hormones and seminal quality in male partners of infertile couples. Andrologia. 2014;47:336–42.
Tetsuka M, Milne M, Simpson GE, Hillier SG. Expression of 11β-hydroxysteroid dehydrogenase, glucocorticoid receptor, and mineralocorticoid receptor genes in rat ovary1. Biol Reproduct. 1999;60:330-5.
Yang J-G, Chen W-Y, Li PS. Effects of glucocorticoids on maturation of pig oocytes and their subsequent fertilizing capacity in VITRO1. Biol Reproduct. 1999;60:929-36.
Van Merris V, Van Wemmel K, Cortvrindt R. In vitro effects of dexamethasone on mouse ovarian function and pre-implantation embryo development. Reproduct Toxicol. 2007;23:32-41.
Zorn B. Decline in sex ratio at birth after 10-Day War in Slovenia: Brief communication. Human Reproduct. 2002;17:3173-7.
Barreiro ML, Gaytan F, Castellano JM, Suominen JS, Roa J, Gaytan M et al. Ghrelin inhibits the proliferative activity of immature leydig cells in vivo and regulates stem cell factor messenger ribonucleic acid expression in rat testis. Endocrinology. 2004;145:4825-34.
Wall-Wieler E, Robakis TK, Lyell DJ, Masarwa R, Platt RW, Carmichael SL. Benzodiazepine use before conception and risk of ectopic pregnancy. Human Reproduct. 2020;35:1685-92.
McGregor RA, Poppitt SD. Milk protein for improved Metabolic Health: A review of the evidence. Nutrit Metabol. 2013;10:46.
Kim JH, Desor D, Kim YT, Yoon WJ, Kim KS, Jun JS et al. Efficacy of αs1-casein hydrolysate on stress-related symptoms in women. Eur J Clin Nutr. 2006;61:536-41.
Mizuno S, Matsuura K, Gotou T, Nishimura S, Kajimoto O, Yabune M et al. Antihypertensive effect of casein hydrolysate in a placebo-controlled study in subjects with high-normal blood pressure and mild hypertension. Bri J Nutr. 2005;94:84-91.
Miclo L, Perrin E, Driou A, Papadopoulos V, Boujrad N, Vanderesse R et al. Characterization of α‐casozepine, a tryptic peptide from bovine αs1‐casein with benzodiazepine‐like activity. FASEB J. 2001;15:1780-2.
Messaoudi M, Lefranc-Millot C, Desor D, Demagny B, Bourdon L. Effects of a tryptic hydrolysate from bovine milk αS1–Casein on hemodynamic responses in healthy human volunteers facing successive mental and physical stress situations. Eur J Nutr. 2004;44:128-32.
Boulier A, Violle N. Evaluation of the mechanism of action of LACTIUM®, a milk hydrolysate enriched in alpha-casozepine with anxiolytic properties. Nutrition. 2018.
Messaoudi M, Lefranc–Millot C, Desor D, Demagny B, Bourdon L. Effects of a tryptic hydrolysate from bovine milk αS1–Casein on hemodynamic responses in healthy human volunteers facing successive mental and physical stress situations. Eur J Nutr. 2004;44:128-32.
Lanoir D, Canini F, Messaoudi M. Long term effects of bovine milk alpha-S1 casein hydrolysate on healthy low and high stress responders. Stress. 2002;5:124.
Kim JH, Desor D, Kim YT, Yoon WJ, Kim KS, Jun JS et al. Efficacy of αs1-casein hydrolysate on stress-related symptoms in women. Eur J Clin Nutr. 2006;61:536-41.
Buysse DJ, Reynolds CF, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality index: A new instrument for psychiatric practice and Research. Psychiat Res. 1989;28:193-213.
Saint-Hilaire Zde, Messaoudi M, Desor D, Kobayashi T. Effects of a bovine alpha S1-casein tryptic hydrolysate (Cth) on sleep disorder in Japanese general population. Open Sleep J. 2009;2:26-32.
dela Peña IJ, Kim HJ, de la Peña JB, Kim M, Botanas CJ, You KY, et al. A tryptic hydrolysate from bovine milk αs1-casein enhances pentobarbital-induced sleep in mice via the Gabaa receptor. Behavioural Brain Res. 2016;313:184-90.
Miclo L, Perrin E, Driou A, Papadopoulos V, Boujrad N, Vanderesse R et al. Characterization of α‐casozepine, a tryptic peptide from bovine αs1‐casein with benzodiazepine‐like activity. FASEB J. 2001;15:1780-2.
Kahathuduwa CN, Dassanayake TL, Amarakoon AM, Weerasinghe VS. Acute effects of theanine, caffeine and theanine-caffeine combination on attention. Nutr Neurosci. 2016;20:369-77.
Kimura K, Ozeki M, Juneja LR, Ohira H. L-theanine reduces psychological and physiological stress responses. Biol Psychol. 2007;74:39-45.
Hidese O, Ota I, Yasukawa O. Effects of L-theanine administration on stress-related symptoms and cognitive functions in healthy adults: A randomized controlled trial. Nutrients. 2019;11:2362.