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August 24, 2015

GUR Professional TLG photoCOLUMBUS, Ohio – More than one quarter of Americans suffer from some form of mental illness and the number of patients treated with antidepressants continues to rise. Additionally, anxiety and depression are becoming more prevalent among couples trying to have children, and so medications prescribed to treat these disorders are also increasingly common. What isn’t clear is the impact mental health and the use of such treatments has on fertility, and whether untreated mental illness is detrimental to fertility. 

Previous research suggests that severe depression and anxiety may have an effect on an unborn child’s central nervous system, however more studies are necessary to shed light on whether mental illness itself has any effect on the reproduction process, as well as the medications prescribed to these patients, according to researchers at The Ohio State University Wexner Medical Center.

A study reviewing a total of 37 studies regarding effect(s) mental illness and antidepressants have on fertility recently published in the Journal of Clinical Psychiatry. Clinical studies didn’t show sufficient evidence to prove the use of antidepressants had detrimental effects on pregnancy rates.

“Increasing knowledge of consequences of mental illness and its prescribed treatment on reproductive health is important for patients and clinicians when making decisions affecting the patient’s health and the health of their unborn child,” said Dr. Tamar Gur, a psychiatrist and women’s health expert at Ohio State’s Wexner Medical Center and principal investigator of the study. Gur co-authored the research with Dr. Brett Worly, an assistant professor of obstetrics and gynecology and female sexual dysfunction expert at OSU Wexner Medical Center.

Review of the literature showed inconclusive results regarding the effect of antidepressants on sperm. Some clinical studies showed an increase in quantity with certain medications. Other research showed a decrease in the number of sperm and viability. According to the data, male depression didn’t affect sperm, but anxiety did.

The majority of studies examined showed maternal psychiatric illness is associated with a low fertility success rate, lower rates of retrieval of the cells necessary for reproduction to occur, lower rates of successful pregnancies and impairment of the stress system.

“Ideally, physicians would be able to tell if psychiatric disorders will impact a couple’s ability to have children. Or, if prescribing treatment would have an adverse effect on their fertility.” Gur said.

Gur cautions that untreated mental illness is problematic, and risks and benefits of treatment must be carefully weighed. “Ultimately, this is a highly personal decision for a couple to make, there is not a “one-size-fits all approach” Gur added. 

Gur recommends meeting with knowledgeable physicians, in order to come up with a treatment philosophy that respects everyone’s needs. She concludes that more research surrounding negative effects of depression and anxiety, as well as its treatment, on the reproductive system is critical. 

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Contact: Sherri Kirk, Wexner Medical Center Public Affairs and Media Relations, 614-293-3737, or Sherri.Kirk@osumc.edu