Fertility and depression

 

fertility, pregnancy, miscarriage, depression

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Many people with Hashimoto thyroiditis experience problems to conceive or/and have a higher chance to have problematic pregnancy. Psychological problems as depression are also often going hand in hand with Hashimoto’s.

Depression is even more common in women with infertility. Women with depression are less likely to conceive and have a lower live birth rate after in vitro fertilization (IVF) treatment. Similarly, men seeking fertility treatments also have an increased prevalence of depression. 49.1% of men undergoing IVF treatments are suffering from depression. Psychological stress is influencing hormones. The activation of hypothalamic–pituitary–adrenal axis plays a key role in the neuroendocrine response to stress. Acute stress suppresses hypothalamic– pituitary–ovarian axis through inhibition of gonadotropin releasing hormone (GnRH) secretion (responsible for the release of follicle-stimulating hormone (FSH) and luteinizing hormone), thereby suppressing of luteinizing hormone release (substance that keeps the testicles and ovaries from making sex hormones by blocking other hormones that are needed to make them) from the pituitary.

Depression is often treated with antidepressant medication. Antidepressant use in pregnancy has been associated with an increased risk of pregnancy complications, including miscarriage.

Most studies investigating depression, fertility, and pregnancy outcomes focus on the female partner. Though, there is a body of literature about the effect of depression on semen parameters.

Despite its limitations: combining data from two patient populations (Polycystic Ovarian Syndrome vs. unexplained infertility), recent study shows that currently active depression in the female partner does not negatively affect non-IVF treatment outcomes. Yet, currently active depression in the male partner may lower the likelihood of pregnancy. Furthermore antidepressant usage in pregnancy has been associated with an increased risk of pregnancy complications,  including miscarriage. Maternal antidepressant use is associated with first-trimester pregnancy loss, which may depend upon the type of antidepressant.

 

 

References:

Bhongade, M. B., Prasad, S., Jiloha, R. C., Ray, P. C., Mohapatra, S., & Koner, B. C. (2015). Effect of psychological stress on fertility hormones and seminal quality in male partners of infertile couples. Andrologia, 47(3), 336-342. doi:10.1111/and.12268

Demyttenaere, K., Bonte, L., Gheldof, M., Vervaeke, M., Meuleman, C., Vanderschuerem, D., & D’Hooghe, T. (1998). Coping Style and Depression Level Influence Outcome in In Vitro Fertilization. Fertility and Sterility, 69(6), 1026-1033. doi:10.1016/s0015-0282(98)00089-2

Evans-Hoeker, E. A., Eisenberg, E., Diamond, M. P., Legro, R. S., Alvero, R., Coutifaris, C., . . . Witter, F. (2018). Major depression, antidepressant use, and male and female fertility. 109. doi:10.1016/j.fertnstert.2018.01.029

Gollenberg, A. L., Liu, F., Brazil, C., Drobnis, E. Z., Guzick, D., Overstreet, J. W., . . . Swan, S. H. (2010). Semen quality in fertile men in relation to psychosocial stress. Fertility and Sterility, 93(4), 1104-1111. doi:10.1016/j.fertnstert.2008.12.018

Mollaoğlu, M., Tuncay, F. Ö., & Fertelli, T. K. (2013). Investigating the sexual function and its associated factors in women with chronic illnesses. Journal of Clinical Nursing, 22(23-24), 3484-3491. doi:10.1111/jocn.12170

 

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