Major depression, antidepressant use, and male and female fertility

Reproductive Medicine Network

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Objective: To determine if maternal major depression (MD), antidepressant use, or paternal MD are associated with pregnancy outcomes after non-IVF fertility treatments. Design: Cohort study. Setting: Clinics. Patient(s): Participants in two randomized trials: PPCOS II (clomiphene citrate versus letrozole for polycystic ovary syndrome), and AMIGOS (gonadotropins versus clomiphene citrate versus letrozole for unexplained infertility). Intervention(s): Female and male partners completed the Patient Health Questionnaire (PHQ-9). Female medication use was collected. PHQ-9 score ≥10 was used to define currently active MD. Main Outcome Measure(s): Primary outcome: live birth. Secondary outcomes: pregnancy, first-trimester miscarriage. Poisson regression models were used to determine relative risks after adjusting for age, race, income, months trying to conceive, smoking, and study (PPCOS II versus AMIGOS). Result(s): Data for 1,650 women and 1,608 men were included. Among women not using an antidepressant, the presence of currently active MD was not associated with poorer fertility outcomes (live birth, miscarriage), but rather was associated with a slightly increased likelihood of pregnancy. Maternal antidepressant use (n = 90) was associated with increased risk of miscarriage, and male partners with currently active MD were less likely to achieve conception. Conclusion(s): Currently active MD in the female partner does not negatively affect non-IVF treatment outcomes; however, currently active MD in the male partner may lower the likelihood of pregnancy. Maternal antidepressant use is associated with first-trimester pregnancy loss, which may depend upon the type of antidepressant. Clinical Trial Registration Numbers: NCT00719186 and NCT01044862.

Original languageEnglish (US)
Pages (from-to)879-887
Number of pages9
JournalFertility and sterility
Volume109
Issue number5
DOIs
StatePublished - May 2018

Fingerprint

Antidepressive Agents
Fertility
Depression
letrozole
Spontaneous Abortion
Clomiphene
Mothers
Live Birth
First Pregnancy Trimester
Pregnancy
Polycystic Ovary Syndrome
Pregnancy Outcome
Gonadotropins
Infertility
Cohort Studies
Smoking
Outcome Assessment (Health Care)
Clinical Trials
Health

Keywords

  • Infertility
  • antidepressant
  • depression

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

Cite this

Major depression, antidepressant use, and male and female fertility. / Reproductive Medicine Network.

In: Fertility and sterility, Vol. 109, No. 5, 05.2018, p. 879-887.

Research output: Contribution to journalArticle

Reproductive Medicine Network. / Major depression, antidepressant use, and male and female fertility. In: Fertility and sterility. 2018 ; Vol. 109, No. 5. pp. 879-887.
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abstract = "Objective: To determine if maternal major depression (MD), antidepressant use, or paternal MD are associated with pregnancy outcomes after non-IVF fertility treatments. Design: Cohort study. Setting: Clinics. Patient(s): Participants in two randomized trials: PPCOS II (clomiphene citrate versus letrozole for polycystic ovary syndrome), and AMIGOS (gonadotropins versus clomiphene citrate versus letrozole for unexplained infertility). Intervention(s): Female and male partners completed the Patient Health Questionnaire (PHQ-9). Female medication use was collected. PHQ-9 score ≥10 was used to define currently active MD. Main Outcome Measure(s): Primary outcome: live birth. Secondary outcomes: pregnancy, first-trimester miscarriage. Poisson regression models were used to determine relative risks after adjusting for age, race, income, months trying to conceive, smoking, and study (PPCOS II versus AMIGOS). Result(s): Data for 1,650 women and 1,608 men were included. Among women not using an antidepressant, the presence of currently active MD was not associated with poorer fertility outcomes (live birth, miscarriage), but rather was associated with a slightly increased likelihood of pregnancy. Maternal antidepressant use (n = 90) was associated with increased risk of miscarriage, and male partners with currently active MD were less likely to achieve conception. Conclusion(s): Currently active MD in the female partner does not negatively affect non-IVF treatment outcomes; however, currently active MD in the male partner may lower the likelihood of pregnancy. Maternal antidepressant use is associated with first-trimester pregnancy loss, which may depend upon the type of antidepressant. Clinical Trial Registration Numbers: NCT00719186 and NCT01044862.",
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AU - Evans-Hoeker, Emily A.

AU - Eisenberg, Esther

AU - Diamond, Michael Peter

AU - Legro, Richard S.

AU - Alvero, Ruben

AU - Coutifaris, Christos

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AU - Christman, Gregory M.

AU - Hansen, Karl R.

AU - Zhang, Heping

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AU - Dodson, W.

AU - Estes, S.

AU - Gnatuk, C.

AU - Ladda, R.

AU - Ober, J.

AU - Brzyski, R.

AU - Easton, C.

AU - Hernandez, A.

AU - Leija, M.

AU - Pierce, D.

AU - Robinson, R.

AU - Ager, J.

AU - Awonuga, A.

AU - Cedo, L.

AU - Cline, A.

AU - Collins, K.

AU - Krawetz, S.

AU - Puscheck, E.

AU - Singh, M.

AU - Yoscovits, M.

AU - Lecks, K.

AU - Martino, L.

AU - Marunich, R.

AU - Comfort, A.

AU - Crow, M.

AU - Hohmann, A.

AU - Mallette, S.

AU - Smith, Y.

AU - Randolph, J.

AU - Fisseha, S.

AU - Ohl, D.

AU - Ringbloom, M.

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N2 - Objective: To determine if maternal major depression (MD), antidepressant use, or paternal MD are associated with pregnancy outcomes after non-IVF fertility treatments. Design: Cohort study. Setting: Clinics. Patient(s): Participants in two randomized trials: PPCOS II (clomiphene citrate versus letrozole for polycystic ovary syndrome), and AMIGOS (gonadotropins versus clomiphene citrate versus letrozole for unexplained infertility). Intervention(s): Female and male partners completed the Patient Health Questionnaire (PHQ-9). Female medication use was collected. PHQ-9 score ≥10 was used to define currently active MD. Main Outcome Measure(s): Primary outcome: live birth. Secondary outcomes: pregnancy, first-trimester miscarriage. Poisson regression models were used to determine relative risks after adjusting for age, race, income, months trying to conceive, smoking, and study (PPCOS II versus AMIGOS). Result(s): Data for 1,650 women and 1,608 men were included. Among women not using an antidepressant, the presence of currently active MD was not associated with poorer fertility outcomes (live birth, miscarriage), but rather was associated with a slightly increased likelihood of pregnancy. Maternal antidepressant use (n = 90) was associated with increased risk of miscarriage, and male partners with currently active MD were less likely to achieve conception. Conclusion(s): Currently active MD in the female partner does not negatively affect non-IVF treatment outcomes; however, currently active MD in the male partner may lower the likelihood of pregnancy. Maternal antidepressant use is associated with first-trimester pregnancy loss, which may depend upon the type of antidepressant. Clinical Trial Registration Numbers: NCT00719186 and NCT01044862.

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KW - antidepressant

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