Mental health during and after pregnancy in medically assisted reproduction: a danish cohort study

Infertility is common and an increasing number of women go through medically assisted reproduction (fertility treatment) to achieve pregnancy. This may affect mental health. We examined if fertility treatment and the specific fertility treatment method used (in vivo or in vitro) were associated with impaired mental health during or after pregnancy.

Using self-reported data from the Odense Child Cohort, we assessed prenatal stress by the 10-item Cohen Perceived Stress Scale (PSS-10) during pregnancy at median gestational week 27 and postnatal depressive symptoms by the Edinburgh Postnatal Depression Scale (EPDS) at median postpartum week 15. We compared fertility-treated women overall and by fertility treatment method to women who conceived spontaneously. We conducted linear regression analyses to evaluate the PSS-10 score dimensionally and logistic regression to evaluate EPDS scores above cut-off (≥ 11).

A total of 108 of 820 women (13%) gave birth after fertility treatment. Their prenatal mean stress (PSS-10) score was 11.38 compared to 11.78 for women who conceived spontaneously, leading to an adjusted mean difference of -0.09 points (95% confidence interval (CI): -1.88 to 1.69). In the fertility-treated group, 9.7% had EPDS scores ≥ 11 compared to 10.7% in the spontaneous conception group (adjusted odds ratio of 0.71 (95% CI: 0.26 to 1.91)). The MAR method (in vivo/vitro) did not influence these results.

Women who gave birth after fertility treatment did not report higher levels of prenatal stress or postpartum depressive symptoms than women who conceived spontaneously.