Stress-associated ovarian damage, infertility, and delay in achieving pregnancy and treatment options

Many types of stress, including psychological stress, negatively affect reproductive health. This study aimed to investigate the effects of sertraline (a selective serotonin reuptake inhibitor), cerebrolysin (neuroprotective/neurotrophic), and a combination of both against stress-induced ovarian damage, infertility and pregnancy delay in female rats. The rats were divided into five groups (n=14/each group) as healthy (HG), stress control (StC), stress+sertraline (SS), stress+cerebrolysin (SC), and stress+sertraline+cerebrolysin (SSC). To induce stress, animals (except the HG) were kept in a supine position with their forelimbs and hindlimbs (FIM) tied for one hour. Then, sertraline (20mg/kg) was given orally to the SS. Cerebrolysin (2.5ml/kg) was injected into the SC subcutaneously. Sertraline+cerebrolysin was administered to SSC with the same methods and doses. FIM and drug administration continued for 30 days. Six rats from each group were euthanized with high-dose anesthesia, right and left ovarian tissues were removed, and tissues were examined biochemically and histopathologically. The remaining rats were taken for breeding. Exposure to stress in rats caused an increase in malondialdehyde (MDA), tumor necrosis factor-alpha (TNF-alpha), interleukin-1 beta (IL-1 beta), and interleukin-6 (IL-6) levels and a decrease in total glutathione (tGSH). Stress was related to histopathological damage, infertility, and delayed birth. The sertraline and cerebrolysin combination was the most effective in preventing these changes, with sertraline and cerebrolysin alone in second and third places, respectively. Regarding efficacy, selective serotonin reuptake inhibitors (SSRIs) and related drugs may be beneficial in treating stress-related ovarian damage, infertility, and delay in pregnancy.