Male depression may lower pregnancy chances among infertile couples

Among couples being treated for infertility, depression in the male partner was linked to lower pregnancy chances, while depression in the female partner was not found to influence the rate of live birth, according to a study funded by the National Institutes of Health.

The study, which appears in Fertility and Sterility, also linked a class of antidepressants known as non-selective serotonin reuptake inhibitors (non-SSRIs) to a higher risk of early pregnancy loss among females being treated for infertility. SSRIs, another class of antidepressants, were not linked to pregnancy loss. Neither depression in the female partner nor use of any other class of antidepressant were linked to lower pregnancy rates.

“Our study provides infertility patients and their physicians with new information to consider when making treatment decisions,” said study author Esther Eisenberg, M.D., of the Fertility and Infertility Branch at NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), which funded the study.

Citing previous studies, the authors noted that 41 percent of women seeking fertility treatments have symptoms of depression. In addition, a study of men seeking IVF treatments found that nearly 50 percent experienced depression. The authors conducted the current study to evaluate the potential influence of depression in couples seeking non-IVF treatments.

The researchers combined data from two previous studies funded by NICHD’s Reproductive Medicine Network. One study compared the effectiveness of two ovulation-inducing drugs for establishment of pregnancy and live birth in women with polycystic ovary syndrome. The other study compared the effectiveness of three ovulation-inducing drugs at achieving pregnancy and live birth in couples with unexplained infertility. In each study, men and women responded to a questionnaire designed to screen for depression. Only the women were asked whether they were taking any antidepressants.

From the two studies, the researchers analyzed data for 1,650 women and 1,608 men. Among the women, 5.96 percent were rated as having active major depression, compared to 2.28 percent of the men.

Women using non-SSRIs were roughly 3.5 times as likely to have a first trimester pregnancy loss, compared to those not using antidepressants. Couples in which the male partner had major depression were 60 percent less likely to conceive and have a live birth than those in which the male partner did not have major depression.

The study did not include couples who underwent in vitro fertilization because the authors thought that this procedure could potentially overcome some possible effects of depression, such as reduced sexual desire and lower sperm quality.

Evans-Hoeker, et al. Major depression, antidepressant use and male and female fertility. Fertility and Sterility. https://doi.org/10.1016/j.fertnstert.2018.01.029



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