The relationship between depression and infertility is a complex one. It is common that couples express feelings of sadness, isolation, and outright depression in having to deal with their inability to conceive, especially at certain times of the year such as during the holiday season. It is thus critical for the entire team of caregivers to understand, empathize with, and address these issues as needed in order to optimize the overall experience of fertility assessment and therapy for their patients.
Recently, a study by Dr. Lisa Catapano, Assistant Professor of Psychiatry at George Washington University in Washington, D.C., summarized the issue of depression in women with infertility. The author confirmed that an understanding of the interconnections between mood disorders and infertility is important for improving care in those suffering from these conditions. While studies suggest a correlation between depression and infertility, the precise nature of this relationship is not well defined. Some evidence suggests that depression causes infertility; however, there is also logical reasoning to believe that it is the reverse; i.e. infertility leads to depression. There are studies that show an increased trend of major depressive disorders in infertile women, and conversely, other studies also show decreased fertility rates in women with mood disorders. Whether infertility actually causes depression, or vice‐versa, is less clear. In terms of treatment of depression in infertile women, antidepressant medications have not been shown to affect fertility rates but may increase the risk of miscarriage. With respect to their safety for the growing fetus during and immediately after pregnancy, research has demonstrated some negative effects such as neonatal irritability, reduced birth weight, and others. Current studies do not support an increased risk of birth defects, other than a possible increase in cardiac defects from paroxitene (Paxil). Psychotherapy (talk therapy) on the other hand is a safe, effective, and powerful tool in helping these women both prior to, and during and after, pregnancy.
In summary, the relationship between infertility and depression in women remains multifaceted and somewhat complicated to define. Despite the fact that the majority of infertile women do not develop depression, understanding the sources of vulnerability and strength in these patients and providing emotional support may ultimately be the key to improving the overall experience, and specifically the mental health, of women with infertility.