Are repeated assisted reproductive technology treatments and an unsuccessful outcome risk factors for unipolar depression in infertile women?
Level 3 - non-randomized controlled study
Nationwide register-based controlled cohort study
PubMed 26234480 · doi:10.1111/aogs.12705
What was done
A nationwide register-based cohort study (the Danish National ART-Couple Cohort) assessed whether women without a live birth after assisted reproductive technology (ART) had a higher risk of unipolar depression compared with women who had a live birth after ART. The study included 41,050 women undergoing ART in Denmark between January 1, 1994, and September 30, 2009. Depression diagnoses were obtained from the Danish Psychiatric Central Research Register, and data were analyzed using Cox proportional hazards regression over 308,494 person-years of follow-up.
What was found
Across follow-up, 552 women were diagnosed with unipolar depression. Women in ART treatment with no live birth yet had a lower risk of depression compared with women who had a live birth. The highest risk was observed 0–42 days after a live birth compared with no live birth (adjusted HR 5.08, 95% CI 3.11–8.29). Risk remained elevated, though lower, at 43 days to 1 year and >1 year after live birth.
Why it matters
The study indicates that postpartum transition and motherhood, rather than ART treatment failure, are the primary triggers for severe unipolar depression in women undergoing assisted reproduction.
Limits
The psychiatric registry captures only hospital-treated or specialized care depression, missing milder or outpatient-managed depression. The abstract reports no details on baseline psychiatric history, specific ART failure counts, or psychosocial confounders.
Cited by
- contradicts Nordic registry data shows that individuals whose IVF fails or takes longer than expected are nearly twice as likely to be prescribed antidepressants or antipsychotics.