Infertility and its treatment are enormously stressful. Previous studies have shown that women undergoing infertility treatment are more vulnerable to clinically significant anxiety and depressive symptoms. But what happens when the desired outcome is achieved? Are women who conceive after infertility treatment still at risk for depression?
To answer this question, researchers assessed risk for postpartum depression (PPD) in 3532 primiparous Swedish women who had given birth following in vitro fertilization (IVF). An aged-matched control group of 8553 mothers was randomly selected, and data were gathered from Swedish national medical registers.
Initial analyses showed that PPD was more common in the control group than in the IVF group (0.8 versus 0.4%; P = 0.04); however, this difference disappeared after controlling for potential confounding factors. No woman in either group committed suicide during the first year after childbirth. The factor that most robustly predicted risk for PPD was a history of any psychiatric illness (odds ratio, OR = 25.5).
This study did not observe any evidence to indicate an increased risk of postpartum depression among the women treated with IVF as compared to women who conceived naturally. However, there are some important limitations of this study. In this study, few (<1%) of the women were identified as having PPD, a prevalence which is much lower than 10% to 15% rates of PPD observed in other studies. This is because in this study women with PPD were those who sought psychiatric evaluation and treatment, as opposed to those identified using symptom rating scales. So while we can probably comfortably say that more severe depression is not more common in women conceiving through IVF, it is possible that the prevalence of milder depressive symptoms is different between women who conceive through IVF versus those who conceive naturally.
Ruta Nonacs, MD PhD
Vikström J, Sydsjö G, Hammar M, Bladh M, Josefsson A. Risk of postnatal depression or suicide after in vitro fertilisation treatment: a nationwide case-control study. BJOG. 2015 Dec 10. [Epub ahead of print]