Summary: According to researchers, women who are severely depressed have decreased chances of becoming pregnant.
Source: Boston University Medical Center.
Women with severe depressive symptoms have a decreased chance of becoming pregnant, while the use of psychotropic medications does not appear to harm fertility, a study by researchers from the Boston University Schools of Public Health and Medicine shows.
The study, published in the American Journal of Obstetrics and Gynecology, found a 38 percent decrease in the average probability of conception in a given menstrual cycle among women who reported severe depressive symptoms, compared to those with no or low symptoms. The results were similar, regardless of whether the women were on psychotropic medications.
Despite associations in prior studies between infertility and the use of antidepressants, antipsychotics or mood stabilizers among already infertile women, “current use of psychotropic medications did not appear to harm the probability of conception,” said lead author Yael Nillni, an assistant professor of psychiatry at the School of Medicine and a researcher with the National Center for PTSD, Women’s Health Sciences Division of the VA Boston Healthcare System. “Our findings suggest that moderate to severe depressive symptoms, regardless of current psychotropic medication treatment, may delay conception.”
Although the study does not answer why women with more depressive symptoms may take longer to become pregnant, the authors noted several potential mechanisms for future study. Depression has been associated with dysregulation of the hypothalamic-pituitary-adrenal axis, which may influence the menstrual cycle and affect the ability to conceive, for example.
Data for the study came from more than 2,100 female pregnancy planners, ages 21-45 years, enrolled in a BU-led study known as PRESTO (Pregnancy Study Online) that is looking at factors influencing fertility. The participants were asked to report their current depressive symptoms and psychotropic medication use, among many other factors. Overall, 22 percent reported a clinical diagnosis of depression in their medical histories, while 17.2 percent were former users of psychotropic medication, and 10.3 percent were current users of psychotropic drugs.
Among the study’s secondary findings was that current use of benzodiazepines – sedatives used to treat anxiety and other disorders – was associated with a decrease in fecundability. Also, women who were formerly treated with a class of antidepressants known as SSRIs (selective serotonin reuptake inhibitors) had improved chances of conception, regardless of depressive symptom severity. The authors speculated that former SSRI users could experience some long-term psychological or neurobiological benefits from past treatment that influence fertility. However, the numbers of individual classes of medications were small, and further study is needed, they said.
An estimated 10 to 15 percent of couples in the U.S. experience infertility. Women have a higher prevalence of depressive and anxiety disorders during their childbearing years than during other times of life, past research suggests.
BU School of Public Health (BUSPH) researchers on the study were: Lauren Wise, Kenneth Rothman and Elizabeth Hatch, professors of epidemiology; Amelia Wesselink, a data analyst on the PRESTO study; and Jaimie Gradus, assistant professor of epidemiology at BUSPH and assistant professor of psychiatry at the BU School of Medicine. Ellen Mikkelsen of Aarhus University, Denmark, also contributed.
Funding: The study was supported by funds from the Boston University Medical Center, the Biotechnology and Biological Sciences Research Council (BBSRC), the Royal Society and the British Heart Foundation.
Source: Lisa Chedekel – Boston University Medical Center
Image Source: This NeuroscienceNews.com image is in the public domain.
Original Research: Abstract for “Depression, anxiety, and psychotropic medication use and fecundability” by Yael I. Nillni, Amelia K. Wesselink, Jaimie L. Gradus, Elizabeth E. Hatch, Kenneth J. Rothman, Ellen M. Mikkelsen, and Lauren A. Wise in American Journal of Obstetrics and Gynecology. Published online April 28 2016 doi:10.1016/j.ajog.2016.04.022
[cbtabs][cbtab title=”MLA”]Boston University Medical Center. “Depression Decreases Chances of Pregnancy in Women.” NeuroscienceNews. NeuroscienceNews, 24 May 2016.
<https://neurosciencenews.com/depression-pregnancy-psychology-4291/>.[/cbtab][cbtab title=”APA”]Boston University Medical Center. (2016, May 24). Depression Decreases Chances of Pregnancy in Women. NeuroscienceNews. Retrieved May 24, 2016 from https://neurosciencenews.com/depression-pregnancy-psychology-4291/[/cbtab][cbtab title=”Chicago”]Boston University Medical Center. “Depression Decreases Chances of Pregnancy in Women.” https://neurosciencenews.com/depression-pregnancy-psychology-4291/ (accessed May 24, 2016).[/cbtab][/cbtabs]
Abstract
Depression, anxiety, and psychotropic medication use and fecundability
Background
The literature regarding the associations among depression, anxiety, and fecundity is inconsistent. While cross-sectional studies suggest that depression and/or anxiety may adversely affect fecundity, the sole cohort study showed only a small association.
Objective
We sought to evaluate the association of self-reported depressive symptoms, self-reported diagnoses of depression and anxiety, and psychotropic medication use with fecundability in a prospective cohort study.
Study Design
Data were derived from Pregnancy Study Online, an Internet-based preconception cohort study of couples attempting to conceive in the United States and Canada. At baseline, female participants completed a survey that assessed demographic information, history of physician-diagnosed depression and anxiety, self-reported depressive symptoms (assessed by the Major Depression Inventory), and use of psychotropic medications. Women completed follow-up surveys every 8 weeks for up to 12 months or until reported conception to assess changes in exposures and pregnancy status. We estimated fecundability ratios and 95% confidence intervals using proportional probabilities regression models. The analysis was restricted to 2146 women who had been attempting to conceive for ≤6 cycles at study entry.
Results
Severe depressive symptoms at baseline, regardless of treatment, were associated with decreased fecundability compared with no or low depressive symptoms (fecundability ratio, 0.62; 95% confidence interval, 0.43–0.91). The fecundability ratio associated with a 10-U increase in Major Depression Inventory score was 0.90 (95% confidence interval, 0.83–0.97). Women who reported moderate to severe depressive symptoms and had never received psychotropic medications (fecundability ratio, 0.69; 95% confidence interval, 0.48–0.99) or who were currently being treated with psychotropic medications (fecundability ratio, 0.72; 95% confidence interval, 0.44–1.20) had decreased fecundability relative to women who had no/mild depressive symptoms and had never used psychotropic medications. Former users of psychotropic medications had increased fecundability regardless of the presence of no/mild depressive symptoms (fecundability ratio, 1.22; 95% confidence interval, 1.06–1.39) or moderate to severe depressive symptoms (fecundability ratio, 1.18; 95% confidence interval, 0.80–1.76).
Conclusion
We found an inverse association between depressive symptoms and fecundability, independent of psychotropic medication use. Use of psychotropic medications did not appear to harm fecundability.
“Depression, anxiety, and psychotropic medication use and fecundability” by Yael I. Nillni, Amelia K. Wesselink, Jaimie L. Gradus, Elizabeth E. Hatch, Kenneth J. Rothman, Ellen M. Mikkelsen, and Lauren A. Wise in American Journal of Obstetrics and Gynecology. Published online April 28 2016 doi:10.1016/j.ajog.2016.04.022
