Assisted conception linked to depression risk

Compared with women who conceive spontaneously, women who become pregnant through assisted reproductive technology, or ART, such as in vitro fertilization, are more likely to suffer from depression before delivery and possibly afterwards.

That finding comes from a study of 87 women, 48 with ART pregnancies and 39 who conceived in the normal way. The characteristics of the women were similar in the two groups.

Dr. Isaac Blickstein and colleagues at the Center of Reproductive Medicine of the Arcispedale Santa Maria Nuova in Reggio Emilia, Italy, evaluated the mothers at 30-32 weeks gestation, and at one week and three months after they gave birth.

“The prevalence of depressed subjects was significantly higher in ART women compared with non-ART women during the antenatal assessment,” the investigators report in the medical journal Fertility and Sterility.

“Assisted reproductive technology pregnancies are more frequently associated with depressive symptoms that may persist after delivery, suggesting a greater emotional vulnerability of these women,” said Dr. Blickstein, who is now with Kaplan Medical Center in Rehovot, Israel.

“Undoubtedly, the depression has a psychological basis,” Blickstein told Reuters Health. “Once a woman is pregnant, there is little residual biological impact on how she conceived, whether it was spontaneous, through in vitro fertilization, ovulation induction, etc.,” he pointed out. “Much more important is the impact of prolonged infertility, futile attempts, and extreme anxiety for a successful outcome.”

Psychological help should be available throughout infertility therapy and during pregnancy, Blickstein said. “The risk of depression during and following ART pregnancies needs monitoring to avoid adverse effects of postpartum depression on the mother-infant relationship and infant’s psychologic development.”

SOURCE: Fertility and Sterility, March 2009.

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