The association between antidepressant use and assisted reproductive technology (ART) treatment in Danish women: A national registry-based cohort study.
Level 3 - non-randomized controlled study
Nationwide non-randomized registry-based matched cohort study
PubMed 33550215 · doi:10.1016/j.ejogrb.2020.12.019
What was done
A Danish nationwide register-based cohort study evaluated women undergoing assisted reproductive technology (ART) between 1995 and 2009 alongside an age-matched comparison group of women who did not initiate ART. All women were nulliparous at study entry and were followed until permanent emigration (>6 months), death, or December 31, 2009. Outcomes assessed were cumulative live birth rates (CLBR), number of initiated ART treatment cycles, and adjusted incidence rate ratios (IRR) for initiating antidepressant use calculated using Poisson regression.
What was found
Women using antidepressants before, during, or after ART were significantly older, had lower CLBR, and initiated fewer ART treatment cycles than ART users not taking antidepressants (exact numerical rates not reported in the abstract). Overall incidence of initiating antidepressants did not differ significantly between ART-treated women and the comparison group. Among women with a live birth, ART-treated women were significantly more likely to initiate antidepressants in the postpartum period compared to non-ART mothers (adjusted IRR = 2.56, 95% CI 1.98–3.30; p < 0.001).
Why it matters
This study shows that while ART treatment itself does not generally increase the rate of antidepressant initiation, successfully delivering a child following ART is associated with a more than twofold increased risk of starting antidepressants postpartum, highlighting a need for psychological surveillance after birth.
Limits
The total sample size and exact numeric values for CLBR and cycle numbers are not reported in the abstract. Data collection concluded in 2009, potentially limiting generalizability to newer ART protocols. The observational registry design could not adjust for all relevant clinical or psychological 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.