Is it tougher to have a child than a failed fertility treatment?
There is no association between clinical depression and failed fertility treatments. Surprisingly, the risk of depression is greater when the treatment is successful, shows new research.
A new study shows that it is tougher to have a child than it is to go through an unsuccessful attempt at artificial insemination.
According to the study, the risk of being hospitalised with clinical depression is greater for women who became pregnant after fertility treatment than it is for those whose treatment failed.
"Overall, the results are surprising. We expected that women who are unsuccessful with fertility treatment would be at greater risk of developing depression, but actually we see the opposite," says lead author Camilla Sandal Sejbæk, a PhD student at the Department of Public Health at the University of Copenhagen, Denmark.
Sejbæk and colleagues studied 41,050 women, who all had fertility treatment between 1994 and 2009 and had not been previously diagnosed with mental health issues.
They found that 552 of these women had been treated in psychiatric hospitals for depression after receiving fertility treatment. Of these women, 355 had had a child.
No matter how many fertility treatments the women had had, the risk of being clinically diagnosed with depression remained highest in those women who had conceived.
Postnatal depression may explain it
The scientists behind the study have a suggestion as to why new mothers may be more prone to depression. Whilst this study cannot confirm it, they believe that many of the registered cases of depression are postnatal.
"We shouldn’t underestimate how hard it is to undergo fertility treatment, but it is also really hard to actually have a child," says Sejbæk.
"In fact, women are most at risk of developing depression shortly after giving birth."
Professor Lisbeth Knudsen from the Department of Sociology at Aalborg University, Denmark, has also conducted research into the consequences of infertility. For her, the fact that new mothers are prone to depression is the crucial message of the study:
"I imagine that the focus in fertility clinics is mostly on those who did not conceive. But these results are a reminder that we should also be aware of those who do get pregnant," says Knudsen.
Contradicts previous research
According to Trille Kjær, a researcher with the Danish Cancer Society, the new study completely contradicts previous research, which shows that unsuccessful fertility treatments lead to symptoms of depression in women.
Kjær’s own research has shown that the likelihood of suicide is higher among women who do not become pregnant after fertility treatment, and that divorce rates are highest amongst couples seeking treatment.
"The new study may seem contradictory because of how they collected the information--by only using the most severe cases where someone is admitted to a psychiatric hospital," says Kjær.
Sejbæk points out that the Psychiatric Central Register used in the study only contains information of hospitalised cases of clinical depression.
According to Sejbæk, there may well be many more cases of women who sought treatment elsewhere, for example with their local doctor or a private psychologist or psychiatrist, and these women would not appear on the register used in the new study.
She also thinks that the experimental design has big impacts on the study results.
"Previous research has asked women directly, how they feel, and there is a big difference between their responses and what a doctor might say on their behalf,” she says.
Helping women to feel more confident
Sejbæk suggests that whilst the study cannot stand alone, it is nonetheless an important contribution.
"I think it's important to realise that fertility treatment itself does not seem to be a triggering factor for severe depression," she says.
"It means that women undergoing fertility treatment can feel more at ease. This may reassure them that it is okay to feel sad, and it does not mean that they will develop outright depression," says Sejbæk.
Translated by: Catherine Jex
- “Are repeated assisted reproductive technology treatments and an unsuccessful outcome risk factors for unipolar depression in infertile women?”, 2015, Acta Obstetricia et Gynecologica Scandinavica, DOI: 10.1111/aogs.12705