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Depression, anxiety, and antidepressant treatment in women: association with in vitro fertilization outcome
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2016 (English)In: Fertility and Sterility, ISSN 0015-0282, E-ISSN 1556-5653, Vol. 105, no 6, 1594-U285 p.Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: To investigate associations between depression, anxiety, and antidepressants before in vitro fertilization (IVF) and IVF cycle outcomes, including pregnancy, live birth, and miscarriage.

DESIGN: Nationwide register-based cohort study.

SETTING: Not applicable.

PATIENT(S): Nulliparous women undergoing their first IVF cycle recorded in the Swedish Quality Register of Assisted Reproduction, January 2007 to December 2012 (n = 23,557).

INTERVENTION(S): Not applicable.

MAIN OUTCOME MEASURE(S): Associations between diagnoses of depression/anxiety, antidepressants, and IVF cycle outcome evaluated using logistic regression to produce adjusted odds ratios (AOR) and 95% confidence intervals (CI).

RESULT(S): In total, 4.4% of women had been diagnosed with depression/anxiety and/or dispensed antidepressants before their IVF first cycle. The odds for pregnancy and live birth were decreased (n = 1,044; AOR = 0.86; 95% CI, 0.75-0.98; and AOR = 0.83; 95% CI, 0.72-0.96, respectively). For women with a prescription for a selective serotonin reuptake inhibitor (SSRI) only (n = 829), no statistically significant associations were found. Women with non-SSRI antidepressants (n = 52) were at reduced odds of pregnancy (AOR = 0.41; 95% CI, 0.21-0.80) and live birth (AOR = 0.27; 95% CI, 0.11-0.68). Women with a depression/anxiety diagnosis with no antidepressant (n = 164) also had reduced odds of pregnancy (AOR = 0.58; 95% CI, 0.41-0.82) and live birth (AOR = 0.60; 95% CI, 0.41-0.89). Among the women who became pregnant (39.7%), there were no statistically significant associations between exposure and miscarriage except for the women taking non-SSRI antidepressants (AOR = 3.56; 95% CI, 1.06-11.9).

CONCLUSION(S): A diagnosis of depression/anxiety and/or treatment with antidepressants before IVF was slightly associated with reduced odds of pregnancy and live birth. Women with the presence of depression/anxiety without antidepressants had a more pronounced reduction in odds, implying that the underlying disorder is important for the observed association.

Place, publisher, year, edition, pages
2016. Vol. 105, no 6, 1594-U285 p.
Keyword [en]
Antidepressants; depression; epidemiology; in vitro fertilization; IVF outcome
National Category
Psychiatry Obstetrics, Gynecology and Reproductive Medicine
URN: urn:nbn:se:uu:diva-279171DOI: 10.1016/j.fertnstert.2016.01.036ISI: 000377290900035PubMedID: 26920258OAI: oai:DiVA.org:uu-279171DiVA: diva2:907643
EU, FP7, Seventh Framework Programme, 259679Swedish Research Council, K2011-69X-21871-01-6The Karolinska Institutet's Research Foundation
Available from: 2016-02-29 Created: 2016-02-29 Last updated: 2016-08-29Bibliographically approved

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