Depression & Infertility - How Are They Related

Infertility & depression are symbiotic and often go together. We have come across different cases of depression during pregnancy & post pregnancy which are very more common among women with a history of infertility treatment. However, many of you may not know that women who experience depression can also be the prey of infertility.
It is absolutely natural to feel sad or depressed while dealing with infertility. Any woman facing it might hit with the blues when her period comes when her fertility test shows a negative report, when fertility treatments fail or when her friends have their second child. Women who are unable to bear child often feel incomplete from inside and the pressure from their family and society, lead to acute depression & isolation.

In our country where family status especially childbearing is considered overly important and valuable to stabilize the family and increases marital satisfaction which otherwise results in marital problems such as divorce or even second marriage, making the situation worse for women with infertile issues.

Depression Causes Infertility

Though it is yet to be proved that depression is directly associated with infertility, some researchers from Central Asia & the USA have found a correlation between depression and increased rate of infertility.

Depression interferes with the process of conception. During this period, you should try to stay relaxed, happy and tension free. Depression affects the functioning of the hypothalamus, a gland in the brain that regulates your feelings or emotions & appetite, as well as the hormones that dictate your ovaries to release eggs. If you're depressed, you may ovulate later in your cycle or not at all. Therefore, if you're having sexual intercourse around the 14th day, thinking that you're about to ovulate, you may miss your opportunity to conceive.

According to the report of Lapane et al (1995), "Depression affects infertility treatment, follow-up, and hope for the future. It may also influence the intensity and longevity of the relationship of the affected couple. Therefore, depression could also have a role in the pathogenesis of infertility."

Infertility is often associated with mental crises and emotional tensions like anxiety, interpersonal problems, subdued anger, unsatisfactory sexual intercourse, frustration, inferiority feeling, rejected feeling, unconscious guilt feeling and all these feelings lead to mild to severe depression among women. The couples who have experienced failures in Assisted Reproductive Technology ART procedures developed personality maladjustment mainly in the form of depression which affects the treatment in the future.

According to the results of an Iranian study conducted in 2006, depression is more common among infertile couples than fertile couples (p<0.015) and among infertile women 37% had depressive symptoms on the Beck Depression Inventory (BDI), which was twice as common as in the control group. Nelson CJ et al, in 2008, used Center for Epidemiological Studies Depression Scale (CES-D) for depression reports that “19% of women with moderate and 13% with severe depression face infertility issues.”

This condition generally arises due to the overlap of hormonal issues involved in both infertility & depression. Furthermore, depression may trend towards change in lifestyles like overeating or lack of appetite and be over or underweight have a negative impact on fertility.

Treat Depression Before Treating Infertility

Depression often occurs due to lack of attention. Family members especially the spouse should understand the mental health and try to resolve symptoms of depression, including persistent sadness, guilt, sleep & appetite disruption, the absence of pleasure etc.

Mental health of the couple is of vital importance. In case they are planning for conceiving, it should be placed at the top priority during the treatment for infertility. Thus, couples should avoid caffeine, which can cause anxiousness, they should also avoid alcohol, which may worsen depressive symptoms and have ample sleep since sleep disturbance is a common symptom of depression.

In India where a mental disorder is often associated with lunacy, couples hesitate before getting treatment for depression. The situation worsens when depression & infertility coexist. Many couples believe that antidepressants can't be taken while trying to conceive. It is true that some antidepressants have a negative impact on fertility, but not all drugs are associated with it. In fact, some studies have revealed that treatment of depression involving counseling, talk therapy, support groups, mind-body therapies & antidepressants had increased pregnancy success.

Whatever be the situation, consult your doctor in case you're experiencing depression while going through infertility. Genome offers counseling or support groups to deal with such cases for a successful pregnancy. Since fertility drugs can aggravate depression and cause mood swings, talk to your doctor who will adjust your fertility medications and recommend the ones that are less likely to affect your mood.

You can consult with our psychiatrist in the panel in order to determine what mood disturbances you are experiencing and they will certainly help you to address negative thought patterns and challenge feelings of helplessness.

Treatment of depression is crucial for a variety of reasons

• Depression can affect sex life.
• It can have a negative impact on relationships with spouse, friends, and family, and even the moral, confidence & spiritual beliefs.
• Women suffering from depression are more likely to drop out of infertility treatment, thus limiting their chances of conceiving.
• Depressed Women have lower chances of conceiving, even with IVF.

Treatment of depression and its impact on Fertility

There is a direct impact of happiness on fertility. According to the National Institute of Infertility Association, “almost 78% of couples get pregnant post-depression treatment.” It is also observed that couples with severe infertility issues have conceived post adoption of a child. This is because the new child in their life had made their life happier & stress-free. Since Depression & Infertility are intermingled, it is advised to couples who are planning to conceive or undergoing infertility treatment to have faith in the treatment and support each other in every possible way. This year on 7^th April (World Health Day) the World Health Organization (WHO)'s theme was bringing awareness to the oft-neglected illness called depression! Lack of support for people with depression or Mental Health conditions, coupled with a fear of stigma, prevent access to treatment. 

GENOME encourages persons affected by depression to start by talking to their partners, families, friends and doctors/ fertility counselors. Let’s Talk - after all, it’s the starting point for the cure of depression and infertility!