Infertility’s Ties to Male Depression and Female Antidepressant Use

An estimated 1.3 million Americans receive fertility advice or treatment each year.

Research published in Fertility and Sterility shows that, among couples seeking fertility treatment, male depression decreases the chances of a pregnancy that leads to a live birth. Women with depression were slightly more likely to get pregnant.

While female depression was not linked to infertility, female antidepressant use was. Women who used certain drugs had higher chances of first-trimester miscarriage. The study did not gather data on antidepressant use among men.

The study authors say depression is common among people with fertility issues. Previous research found depression rates of 41% among women seeking infertility treatment. A separate study found depression rates of nearly 50% among men seeking in vitro fertilization (IVF) treatment.

Does Depression Affect the Chances of a Successful Pregnancy?

The study used data from two randomized trials of non-IVF treatments. One trial evaluated treatments for polycystic ovary syndrome (PCOS), a common cause of infertility. Another measured the effectiveness of three treatments for unexplained infertility.

The study had a total of 1,650 female and 1,608 male participants. In each trial, men and women were given a questionnaire about depression symptoms. The study found 5.96% of women and 2.29% of men had major depression.

Men with major depression were less likely to get their partners to conceive. They were also less likely to produce a pregnancy resulting in a live birth. Overall, men with depression were 60% less likely to produce a full-term pregnancy.

Women who had depression but took no antidepressants did not see fertility risks. Female depression alone did not increase the risk of miscarriage. Nor did it reduce the likelihood of a life birth. In fact, women with depression had slightly higher chances of pregnancy.

Among the 90 women who did take antidepressants, the risks were different. Miscarriages during the first trimester of pregnancy were more common among these women. However, the type of medication mattered.

• Women who used non-selective serotonin reuptake inhibitors (non-SSRIs) were 3.5 times as likely to have a miscarriage.
• Women taking any other type of antidepressant, including SSRIs, saw no change in pregnancy rates.

These results suggest certain drugs may be riskier for women trying to get pregnant.

Infertility and Mental Health

Infertility can cause tremendous stress for men and women. One study interviewed 200 male-female couples at a fertility clinic. Half of the women said infertility was the most stressful experience of their lives. Fifteen percent of men with infertility said the same.

Fertility issues can affect both individual well-being and a couple’s relationship. Therapy may help couples navigate the challenges of infertility. A therapist can help couples find treatment options that match their values.

Depression may be triggered by infertility, or it could be a preexisting condition. No matter the cause, depression is treatable. The right therapy can help people manage their symptoms and learn coping strategies. Therapy can be especially helpful for those who want to avoid antidepressants due to fertility concerns.

References:

1. Evans-Hoeker, E. A., Eisenberg, E., Diamond, M. P., Legro, R. S., Alvero, R., Coutifaris, C., . . . Steinger, A. Z. (2018). Major depression, antidepressant use, and male and female fertility. Fertility and Sterility, 109(5), 879-887. Retrieved from https://www.fertstert.org/article/S0015-0282(18)30029-3/fulltext
2. Male depression may lower pregnancy chances among infertile couples, NIH study suggests. (2018, May 17). EurekAlert. Retrieved from https://www.eurekalert.org/pub_releases/2018-05/nksn-mdm051518.php
3. The psychological impact of infertility and its treatment. (2009). Harvard Mental Health Letter. Retrieved from https://www.health.harvard.edu/newsletter_article/The-psychological-impact-of-infertility-and-its-treatment

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