Abstract
BACKGROUND: Infertility affects approximately 15% of couples globally and is recognized as a major public health concern. Infertile women often experience significant psychological stress due to various factors, including work-related pressures, family dynamics, and reproductive challenges. However, the role of allostatic load-a marker of chronic stress and physiological dysregulation-in infertile women has been scarcely investigated. PURPOSE: This study aimed to explore the association between allostatic load and infertility, as well as to identify potential biomarkers that can predict allostatic load in infertile women. METHOD: The study included 419 participants from the 2015-2018 National Health and Nutrition Examination Survey (NHANES), comprising 59 individuals with infertility and 360 controls. Allostatic load was assessed using a composite of biomarkers, including diastolic blood pressure (DBP), systolic blood pressure (SBP), body mass index (BMI), abdomen circumference (AC), homeostatic model assessment of insulin resistance (HOMA-IR), triglycerides (TG), low-density lipoprotein (LDL), high-density lipoprotein (HDL), and high-sensitivity C-reactive protein (hs-CRP). Data analysis was performed using R (R Core Team, 2021) and IBM SPSS Statistics 22.0, with statistical significance set at P < 0.05. RESULT: Women with infertility had significantly higher AC, BMI, and SBP, but lower HDL levels compared with controls (all p < 0.05), after weighting, the differences between the two groups in AC, BMI, and HDL remained statistically significant (P = 0.021, 0.035, 0.024. respectively). The allostatic load score was also significantly higher in the infertility group (p = 0.011), after weighting, this difference remained statistically significant (P = 0.029). Subgroup analysis suggested a stronger association between allostatic load and infertility among non-smoking women. BMI, LDL, TG, HDL, and hs-CRP were identified as key biomarkers predictive of allostatic load in infertile women. CONCLUSION: Allostatic load was significantly higher in infertile women, highlighting the importance of assessing allostatic load in clinical management, particularly among non-smoking women. BMI, LDL, TG, HDL, and hs-CRP were identified as key biomarkers associated with allostatic load in this population.