Prevalence and predictors of major depressive disorder for fertility treatment patients and their partners

Capsule:
Major depressive disorder (MDD) is highly prevalent during fertility treatment. A history of MDD increases risk of MDD during treatment, even after controlling for commonly assessed risk factors at treatment entry.

Authors:
Sarah R. Holley, Ph.D., Lauri A. Pasch, Ph.D., Maria E. Bleil, Ph.D., Steven Gregorich, Ph.D., Patricia K. Katz, Ph.D., Nancy E. Adler, Ph.D.

Volume 103, Issue 5, Pages 1332-1339

Abstract:

Objective:
To examine the prevalence and predictors of major depressive disorder (MDD) for women and their partners during the course of fertility treatment.

Design:
Prospective cohort study during an 18-month period. Participants completed interviews and questionnaires at baseline and at 4, 10, and 18 months of follow-up.

Setting:
Five community and academic fertility practices.

Patient(s):
A total of 174 women and 144 of their male partners who did not have a successful child-related outcome during the time frame of the study.

Intervention(s):
No interventions administered.

Main Outcome Measure(s):
The MDD was assessed using the Composite International Diagnostic Interview Major Depression module, a structured diagnostic interview. Additional variables were assessed with self-report questionnaire measures.

Result(s):
Of the women 39.1% and of the men 15.3% met the criteria for MDD during the 18-month course of the study. A binary logistic covariate-adjusted model showed that, for both women and men, past MDD was a significant predictor of MDD during treatment. Past MDD further predicted significant risk for MDD during treatment after controlling for other well-established risk factors (i.e., baseline levels of depression, anxiety, and partner support).

Conclusion(s):
The MDD was highly prevalent for fertility treatment patients and their partners. Past MDD predicted risk for MDD during treatment, and it contributed to MDD risk more than other commonly assessed risk factors. This suggests that patients and their partners would benefit from being routinely assessed for a history of MDD before the start of treatment to best direct psychosocial support and interventions to those most in need.

  • msamplaski

    Interesting and intuitive data; something that clinicians clearly should be aware of. Were any of these men under the care of a psychiatrist or therapist prior to the start of (or during) their fertility journey?

  • A simple yet very revealing study highlighting the psychiatric toll that infertility can take on a couple. The stress of the inability to conceive naturally, timing intercourse, financial toll, hormonal changes with medications, the failure of ART, etc. all have an impact on mental health. Those at risk are those with prior history of depression.

    This study makes a very important point: we as clinicians, although the fertility is our priority, cannot neglect the mental health portion of care for our patient. Whole person care must be provided if possible. If not, at least recognize the mental health stressors, and if the couple are high risk, refer to the proper specialists for mental health care and counseling.

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