Document Type

Thesis

Degree Name

Master of Science (MSc)

Department

Health Science

Faculty/School

Faculty of Science

First Advisor

Nicolas Rouleau

Advisor Role

Thesis Supervisor

Second Advisor

Nirosha J. Murugan

Third Advisor

Crystal Chan

Abstract

Infertility is a deeply distressing condition affecting one in six couples, leading many to seek fertility treatments like in vitro fertilization (IVF), where an egg is fertilized outside the body in a clinical laboratory setting. Prior research highlights the anterior cingulate cortex (ACC) and insula as critical regions involved in interoception and in integrating emotional and autonomic processes. Functional MRI studies during labour and orgasm demonstrate activation in these regions during states associated with increased uterine contractility. Elevated uterine activity may reduce the success of implantation by expelling embryos after transfer. This thesis examines the relationship between cortical activity and reproductive physiology, with a focus on how neural activity in the ACC and insula may relate to uterine contractility and fertility treatment outcomes. Chapter 1 reviews the neural and autonomic regulation of reproductive function. Chapter 2 presents a narrative review examining brain–body dynamics, neurological and psychiatric disorders, and fertility. Chapter 3 investigates cortical activity during the peri-transfer period in patients undergoing a frozen embryo transfer (FET). We performed a transvaginal ultrasound before the FET and two electroencephalograms (EEGs), before and after the procedure, on 31 participants to investigate the brain and uterus in fertility treatment outcomes. Higher perceived stress and anxiety were associated with increased high-frequency cortical activity in frontal and temporal regions. Pregnancy outcomes differed across surface and source-localized EEG measures, with higher post-transfer alpha activity in the insula and ACC associated with reduced odds of pregnancy. Uterine contractile frequency was positively associated with insular alpha activity and predicted by pre-transfer alpha activity in the left insula and right ACC. These findings support a functional relationship between cortical activity and reproductive physiology and provide a foundation for future investigation into neural mechanisms behind fertility treatment outcomes.

Convocation Year

2026

Convocation Season

Spring

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Available for download on Friday, April 16, 2027

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