Re: commentary on ′Decline of semen quality during IVF is not associated with subjective male stress′

We thank the commentator for his valuable insights as expressed in the above commentary. We fully agree that numerous lines of evidence support the assumption that male as well as female stress and the interaction of the stressed couple plays a role in the success of assisted reproduction. Furthermore, it is common ground that in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) couples are an especially vulnerable patient collective in this respect. We have, however, not yet identified the optimal means of measuring stress or the relevant aspects of it during the management of couples undergoing IVF/ICSI. This fact is also highlighted by our findings.1 Further work is necessary to identify efficient and reliable tools to measure and treat stress in males and females undergoing IVF/ICSI with the goal of further improving reproductive outcomes.