Fertility patients along with their partners more likely to suffer from major depressive disorder (MDD)
MDD can lead to feelings of withdrawal and isolation from social activities
Dr Sarah Holley, Assistant Professor of Psychology at San Francisco State MDD “is more serious than experiencing low mood or crying a lot”
New research by scientists at San Francisco State University indicates that people undergoing treatment for infertility, along with their partners, are much more likely to suffer from major depressive disorder (MDD). As a result of the study, doctors are suggesting that fertility treatment providers should include screening for MDD during pre-treatment testing, in order to help patients prevent the disorder taking hold during, or after, the process.
According to Dr Sarah Holley, Assistant Professor of Psychology at San Francisco State and lead author of the study, MDD “is more serious than experiencing low mood or crying a lot, which are some of the things that go into the type of standard depression inventories given to patients. It’s a really debilitating disorder, and actually one of the leading causes of disability in the US”.
The symptoms of MDD can lead to feelings of withdrawal and isolation from social activities, inability to work, and it is a major risk factor for suicide. According to Holley, MDD can lead to people dropping out of fertility treatment, or even if it is ultimately successful, MDD during the process could extend into the prenatal or post-partum periods.
In order to be diagnosed with the disorder, patients must have experienced a depressed mood or intense loss of interest or pleasure, plus four other symptom criteria such as: sleep or appetite disturbance, feelings of worthlessness or guilt, indecision or thoughts of harm to themselves.
The study, which surveyed 174 women and 144 men who had experienced unsuccessful fertility treatment attempts, indicated that fertility patients are notably prone to MDD: 39.1% of the women and 15.3% of the men were considered to fulfi l diagnostic criteria for MDD during the 18-month study period, compared with the annual prevalence for MDD in 8.4% of women and 5.2% of men from the rest of the US population.
Dr Holley and her research team established that the primary predictive indicator for a patient developing MDD during fertility treatment is if they have a past history of the illness, outside of the treatment process.
Scientists compared a patient’s past history of MDD with additional risk factors, such as baseline levels of depression and anxiety, as well as partner support. They concluded that this history was a stronger predictor of whether patients and partners ultimately developed MDD during fertility treatment, in comparison to other, more commonly screened indicators – such as simple enquiries into a patient’s mood and anxiety levels.
It is commonly accepted that MDD is a recurring disease, more likely to take hold during stressful life events. “People often describe fertility treatment as one of the most distressing things they’ve ever experienced,” Dr Holley said. “It’s a prolonged process filled with uncertainty, and often it is very expensive. It can be very physically demanding, especially for women. It can have a profound effect on a couple’s relationship.
“Our research suggests that it would be useful to include an assessment of a history of MDD as part of a pre-treatment screener,” the scientist emphasised. “Helping patients and partners either before the depression takes hold, or being able to identify it and treat it as soon as possible, has the potential to help them through the very stressful process of treatment and possibly beyond,” she said.
The team’s future research aims to assess the rates of MDD among same-sex couples who are undergoing fertility treatment to see whether the risk factors vary for sexual minority patients compared with their heterosexual counterparts