Which statement about stress and fertility is supported by the material?

• A. Stress has no effect on ovulation
• B. Only physical stress affects fertility
• C. Extremely high stress can contribute to anovulation and ovulatory dysfunction
• D. Stress improves fertility

Answer: (C)

Stress can disrupt the brain’s control of reproduction by affecting the hypothalamic-pituitary-ovarian axis. When stress levels are very high or chronic, the hypothalamus reduces the pulsatile release of GnRH, which in turn lowers the downstream secretion of FSH and LH from the pituitary. Without adequate FSH/LH, follicle development and ovulation can be impaired, leading to anovulatory cycles or ovulatory dysfunction. This is seen in scenarios like functional hypothalamic amenorrhea, where intense physical or emotional stress suppresses ovulation. Occasional or mild stress does not reliably prevent ovulation, so the idea that stress has no effect is not accurate. It’s also not limited to physical stress—emotional stress can have a similar impact—and stress whatsoever does not improve fertility.