Major depression in male but not female partners reduces odds of pregnancy in infertile couples

Among infertile couples, currently active major depression (MD) in the male but not the female partner appears to exert a negative effect on non-in vitro fertilization (IVF) treatment outcomes, a study has found. However, maternal use of antidepressants may increase the risk of first-trimester pregnancy loss, depending on the type of drug.

The study included 1,650 women and 1,608 men pursuing non-IVF fertility treatments. All participants completed the Patient Health Questionnaire (PHQ-9), and PHQ-9 score ≥10 was used to define currently active MD. Additionally, data on antidepressant use was collected in female partners. 

Currently active MD was identified in 5.96 percent of women and in 2.28 percent of men. Of all the female participants, 5.72 percent reported taking antidepressant medications.

The average PHQ-9 scores for men with and without currently active MD were 13.41 and 1.21, respectively, and the corresponding live birth rates were 8.82 percent and 24.67 percent. Male partners with currently active MD had lower odds of having their partner achieve conception (relative risk [RR], 0.44; 95 percent CI, 0.20–0.98).

In women, the presence of currently active MD was not associated with poor fertility outcomes but rather with a slightly increased likelihood of pregnancy (RR, 1.38; 1.07–1.78) among those who were not using an antidepressant.

Meanwhile, antidepressant use, particularly non-SSRI (selective serotonin reuptake inhibitor) drugs, in women without currently active MD conferred an increased likelihood of first-trimester miscarriage (RR, 1.87; 1.18–2.99). This association was absent in the group women with currently active MD.

Despite the associations, no significant differences in the primary outcome of live birth rates were observed for any of the groups in women.

Further studies are warranted to confirm the findings, researchers said.