Infertility and Mental Health

Infertility Treatment is Stressful: But Does Stress Affect the Chances of Getting Pregnant?

It is common for women experiencing infertility and undergoing fertility treatment to experience significant emotional distress.  Many women, reasoning that their emotional health influences their physical functioning, worry that the stress and anxiety they experience in this context may hinder their ability to become pregnant.

Metformin May Help to Treat Menstrual Irregularities in Women Treated with Antipsychotics

Menstrual irregularity is a common side effect of antipsychotic treatment in women, occurring more commonly in those treated with risperidone and the older antipsychotic medications. New research presented at the APA earlier this month indicated that the addition of metformin at 500 mg bid resolved menstrual irregularities in most women treated with antipsychotic medications. (Metformin is a medication used alone or with other medications, including insulin, to treat type 2 diabetes.) In addition, women receiving metformin lost an average 2.4 kg of weight after 6 months of treatment.

Serotonin Reuptake Inhibitors and Fertility (Part 2): What Can Basic Science Tell Us?

Serotonin (5-HT) is one of the neurotransmitters involved in mood regulation and has been implicated in the development of mood and anxiety disorders.  Serotonin transporters (SERT) facilitate the transfer of serotonin into neurons; serotonin reuptake inhibitor (SSRI) antidepressants bind to these transporters and appear to exert their effect on mood by inhibiting the reuptake of serotonin and thus increasing the levels of this neurotransmitter at the synapse.

Serotonin Reuptake Inhibitors and Fertility (Part 1): A Clinical Perspective

We previously reported that paroxetine, a selective serotonin reuptake inhibitor (SSRI), may affect sperm motility and may thus have a negative impact on male fertility.  Many women who are planning a pregnancy question whether SSRIs and other antidepressants may affect fertility; this is obviously a particularly important issue for those who are having difficulty conceiving.

Cognitive-Behavioral Therapy for Infertile Women: Is it Better than Medication?

Research indicates that women undergoing infertility treatment experience high rates of psychological distress (1). Additionally, it is believed that stress and depression have an impact on fertility, as it has been shown that certain psychological interventions may improve pregnancy rates in infertile women (2-4). In a recent study, Faramarzi and colleagues compared the effects of group cognitive behavioral therapy (CBT), fluoxetine, and no treatment on the mental health of infertile women who had been trying to conceive for at least 2 years (5).

Depression and Anxiety: Do They Impact Infertility Treatment?

Infertility affects an estimated 10-15% of couples of reproductive age.  Several studies have indicated that patients undergoing in vitro fertilization (IVF) experience high levels of stress, depression, and anxiety.  Multiple risk factors for anxiety and depression during infertility treatment have been identified; these include being female, age over 30, lower level of education, lack of occupational activity, a male cause for infertility, and infertility for 3-6 years.

Paroxetine (Paxil) May Affect Sperm Quality

Within the field of psychiatry, there is a growing body of literature studying the use of antidepressants in women in the context of pregnancy and the postpartum period.  However, much less attention has focused on the impact of these drugs on fertility, particularly in men.  Because major depressive disorders affect about one in 10 American men over their lifetimes, it is essential to study the effects of antidepressants on male fertility.

Impact of Infertility Treatment on Risk for Depression and Anxiety

Infertility and its treatment have been shown to be a trigger for both depression and anxiety.  Women with pre-existing histories of depression and anxiety who have been stable on medication may find themselves with worsening symptoms brought on by the stress involved in the process of infertility treatment.  Many women find the process an emotional roller coaster of hopefulness and disappointment.

Does Depo-Provera Cause Mood Changes?

Depo-Provera (DMPA), also known as the birth control shot, is a highly effective form of contraception that lasts for 3 months, and thus requires only 4 injections per year. DMPA contains a long-lasting form of depot medroxyprogesterone acetate that works as a contraceptive agent by preventing the ovaries from releasing an egg each month. Potential side effects of DMPA include bone density loss, weight gain, and mood worsening. Although depression is listed in the packet insert as a side effect of the injection, available research addressing this side effect are limited and contradictory.

Depression is Common Following Successful IVF

Psychological symptoms play a significant role in infertility. Some studies have examined the impact of psychological symptoms (e.g., anxiety, depression) on fertility status. Most of this research has focused on women with unsuccessful IVF treatment. Some have investigated the extent to which a woman's psychological state during assisted reproductive therapy (ART, which includes in vitro fertilization (IVF)) interferes with the success of the treatment.  ART itself has been shown in other studies to negatively impact a patient's psychological well-being, with prolonged treatment associated with increased depression and anxiety.