Medically assisted reproduction and mental health: a 24-year longitudinal analysis using Finnish register data
Goisis, A., Palma Carvajal, M., Metsä-Simola, N., Klemetti, R., Martikainen, P.
, Myrskylä, M.
, Pelikh, A., Tosi, M., Remes, H. M.
SSRN research paper series 4109037
Posted: 1 June 2022 (2022), unpublished
Background: Medically assisted reproduction (MAR) can negatively impact women’s mental health, particularly when the treatments do not result in a live birth. While the number of women relying on MAR to conceive has grown rapidly, our knowledge about the mental health effects before, during, and after treatment is limited.
Methods: Using Finnish register data on women and linear regression models, we compared antidepressant purchases over 24 years in six-month periods for three groups of women who: 1) gave birth after natural conception (NC), 2) gave birth after MAR treatments (MAR+), or 3) underwent MAR but remained childless (MAR-).
Findings: The results show that women who did not have a live birth after undergoing MAR treatments purchased more antidepressants than women who conceived naturally or through MAR, and that these differences did not attenuate over time (14.1% (95% CI: 13.66-14.62) of MAR- women purchased antidepressants, versus 9.45% of NC (95% CI: 9.36-9.55) and 10.39% (95% CI: 10.07-10.7) of MAR+ women). In contrast, women who conceived naturally and through MAR had very similar antidepressant use from three years before conception to four years after, and over the long term.
Interpretation: The similarities in the antidepressant purchases of women who had a live birth, whether naturally or through MAR, suggest that the higher antidepressant use among women who remained childless after undergoing MAR were likely driven more by involuntary childlessness than by treatment-related stress. The results highlight the importance of counselling for women undergoing MAR treatments, especially if their attempts to conceive are unsuccessful.
Funding: AG, MP, and AP were supported by European Research Council (#803958). PM was supported by the Academy of Finland (#308247, #345219) and European Research Council (#101019329). MM was supported by the Strategic Research Council (SRC), FLUX consortium (#345130 and #345131).