Use of antidepressants and assisted reproductive technology treatment outcomes: a Danish nationwide register-based cohort study.

OBJECTIVE

To examine the association between antidepressants and clinical pregnancy and live birth after embryo transfer in women with mild to moderate depression.

DESIGN

This register-based observational study comprised all Danish women undergoing assisted reproductive technology (ART) treatment from 2006 to 2019.

SUBJECTS: A nationwide cohort of 44,542 women with 123,146 embryo transfers.

EXPOSURE: The exposed cohorts were either women exposed to antidepressants at the time of embryo transfer (current users) or women who discontinued treatment before embryo transfer (recent users), reflecting mild to moderate depression. Women without a history of antidepressant use constituted the unexposed cohort.

MAIN OUTCOME MEASURES: We used a multilevel mixed-effects generalized linear model, accounting for multiple embryo transfers, to examine the chance of clinical pregnancy and live birth after ART treatment in women currently or recently treated with antidepressants, compared with women without antidepressants.

RESULTS

A total of 1,057 women (median age 35 [interquartile range: 31-39]) were current users and had 2,154 embryo transfers, 1,580 women were recent users and had 2,780 transfers, and 42,861 women without use of antidepressants had 118,212 transfers. The relative risk (RR) of clinical pregnancy in women with current use was 0.97 (95% confidence interval [CI]: 0.90-1.04), and 0.94 (95% CI: 0.79-1.11) for live birth. The confounder-adjusted RR was 0.96 (95% CI: 0.87-1.03) for clinical pregnancy, and 0.96 (95% CI: 0.87-1.00) for live birth among current users. For recent users, the RRs of clinical pregnancy, and live birth were 0.94 (95% CI: 0.87-1.00), and 0.99 (95% CI: 0.85-1.14), respectively, and the adjusted RRs 0.94 (95% CI: 0.86-1.01) for clinical pregnancy and 1.04 (95% CI: 0.90-1.20) for live birth.

CONCLUSION

Based on nationwide data from more than a decade, we found that current or recent use of antidepressants at the time of embryo transfer was not associated with a decreased chance of clinical pregnancy or live birth. The findings suggest that for women treated with antidepressants, ART treatment is as successful as for women without.