April 21, 2016

Anxiety and Depression

recurrent miscarriage prevention

Anxiety and depression touch the soul of many. Women who demonstrate are not immune; and in fact, may be more exposed to its effects. It is reported that approximately 10% of women undergoing fertility treatments suffer from depression and 15% report anxiety. These feelings of anxiety and/or depression are not clearly associated with negative fertility treatment outcomes (lack of pregnancy). They are often present prior to ensuing treatment.

Recent studies reported through Scandinavian registry suggested that women undergoing fertility treatments were less likely to be hospitalized for their illness than age-matched controls.  It was postulated that, perhaps, involvement in fertility treatment, staved off the need for hospitalization. It can be inferred that the treatments afforded a positive effect on women with anxiety and depression.

So, it seems that the treatment itself had a positive effect on these women. However, was the converse true? Did these women demonstrate the same pregnancy and live birth rates as their non-affected counterparts undergoing the same treatment? The answer is both yes and no.    The difference is related to concurrent treatment for the anxiety and depression. SSRI (selective serotonin reuptake inhibitors) have been the cornerstone of treatment for mood disorders and the most widely prescribed for women pursuing fertility, expectant mothers and women postpartum. Women with prescriptions (and presumingly taking) the SSRIs demonstrated no diminution in pregnancy, miscarriage and live birth rates when compared  to women not reporting mood disorders and undergoing the same treatment. Those women undergoing IVF with untreated mood disorder faired worse with a slight decrease in pregnancy and live birth rate. There were no changes in the miscarriage rate for treated and untreated women. There is still much to examine regarding anxiety and depression treatment and the effects of the mind-body connection. It is imperative to remember that healthy mothers promote healthy living.

Cesta et al.  Depression, Anxiety and Antidepressant Treatment in Women:  Association With In Vitro Fertilization Outcome. Fertility and Sterility:

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Danielle Vitiello, Ph.D., M.D.

Danielle Vitiello, Ph.D., M.D. Board-Certified in Obstetrics and Gynecology, Reproductive Endocrinology and Infertility