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Depression Is Associated with Infertility in Women, but How?

Estimates of infertility rates in women range from 8% to 33%. While depressed women are known to be less fertile than nondepressed women, possible causes such as antidepressant use, prior pelvic inflammatory disease, smoking, alcohol, and poor nutrition are uncertain. One study reported that women who had a history of having taken antidepressants for more than six months were three times more likely to be infertile than women who had never taken antidepressants. This case-control study examined the relation between a history of depression and infertility in women.

Researchers recontacted 339 female health-survey respondents who reported either a period of infertility (inability to conceive after 12 months of unprotected intercourse) or a pregnancy. Of the 58 women who reported a history of depressive symptoms prior to the period of infertility or pregnancy, 14 (24%) experienced infertility. Of the remaining 281 women who did not report depressive symptoms, only 38 (13%) reported infertility. Women who reported depression were more likely to smoke, have higher or lower extreme body weights, or have a history of sexually transmitted diseases. After controlling for these and other confounding factors (such as sedentary lifestyle, average alcohol use, and history of antidepressant use), women with a history of depression were still almost twice as likely to report infertility as women who did not report depression.

Comment: Although these findings are only based on self-reports and need to be replicated, this survey supports the view that depressed women are less fertile than nondepressed women and that factors other than antidepressant use, smoking, sexually transmitted diseases, and alcohol use contribute to infertility. Other health-related behaviors that may contribute to infertility in women with depression include poor nutrition, decreased sexual behavior, and direct effects of depression or stress on the hypothalamic pituitary axis. Clinicians should keep in mind that not only can infertility be a cause of depression, but pre-existing depression may also be a cause of infertility.

— J Yager

Published in Journal Watch Psychiatry February 1, 1996

Citation(s):

Lapane KL et al. Is a history of depressive symptoms associated with an increased risk of infertility in women? Psychosom Med 1995 Nov/Dec 57 509-513.

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