Antidepressants Linked to Pregnancy Risks in Infertility Tx

No evidence of improved pregnancy outcome; counseling may be effective for depressive symptoms

THURSDAY, Nov. 1 (HealthDay News) -- Physicians who treat infertile women should be aware of the potential risks associated with antidepressant use during pregnancy, and should consider alternative treatments such as some forms of counseling, according to a study published online Oct. 31 in Human Reproduction.

Noting that selective serotonin reuptake inhibitor (SSRI) use is associated with possible reduced infertility treatment efficacy as well as higher rates of adverse pregnancy outcomes, Alice D. Domar, Ph.D., from Boston IVF, and colleagues reviewed the current literature to examine the safety and efficacy of SSRI use in infertile women. All studies that assessed females taking antidepressant medications for depressive symptoms who were experiencing infertility were included.

The researchers found that there were increased risks of miscarriage, birth defects, preterm birth, newborn behavioral syndrome, persistent pulmonary hypertension of the newborn, and possible longer term neurobehavioral effects seen with antidepressant use during pregnancy. No evidence was found for improved pregnancy outcomes with antidepressant use. Noting that some evidence suggests decreases in depressive symptoms with psychotherapy, including cognitive-behavioral therapy and exercise, some forms of counseling were also shown to be effective for treating these symptoms in infertile women.

"Our findings are limited by the availability of published studies in the field, which are often retrospective and of small size," the authors write. "Practitioners who care for infertility patients should have a thorough understanding of the published literature so that they can adequately counsel their patients."

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