Preconception depression reduces fertility: a couple-based prospective preconception cohort

Area of Science:

• Reproductive Medicine
• Mental Health
• Epidemiology

Background:

• Preconception depression in women is known to impair fertility in clinical settings.
• Evidence regarding preconception depression's impact on fertility in the general population, particularly from a couple's perspective, is limited.

Purpose of the Study:

• To investigate the association between preconception depression and time to pregnancy (TTP) and infertility risk in couples.
• To examine the impact of depression in either or both partners on fertility outcomes.

Main Methods:

• A prospective, couple-based cohort study included 16,521 couples attempting conception.
• Depression was assessed using the Patient Health Questionnaire-9 at baseline.
• Fertility odds ratios and infertility risk ratios were analyzed using Cox proportional-hazard models and logistic regression, adjusting for confounders.

Main Results:

• Preconception depression in women was associated with reduced odds of fertility.
• Depression in either partner increased infertility risk (women: RR=1.212; men: RR=1.214).
• Couples with depression in both partners showed reduced fertility (aFOR=0.904) and significantly increased infertility risk (RR=1.469).

Conclusions:

• Preconception depression in individuals and couples negatively impacts fertility.
• The findings highlight the importance of addressing depression in both men and women to enhance fertility.
• Early detection and intervention for depression are recommended to improve conception rates.