Goisis, Alice;
Palma, Maria;
Metsä-Simola, Niina;
Klemetti, Reija;
Martikainen, Pekka;
Myrskylä, Mikko;
Pelikh, Alina;
... Remes, Hanna; + view all
(2023)
Medically assisted reproduction and mental health: a 24-year longitudinal analysis using Finnish register data.
American Journal of Obstetrics and Gynecology
, 228
(3)
311.e1-311.e24.
10.1016/j.ajog.2022.10.041.
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Abstract
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. / Objective: To understand the long-term association between medically assisted reproduction and mental health outcomes for women before, during and after their treatments, and according to whether the treatment resulted in a live birth or not. / Study design: Using Finnish register data for the period 1995-2018 we estimated the probability of psychotropic purchases (antidepressants, anxiolytics, hypnotics and sedatives) 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-). We followed women for up to 12 years before and 12 years after the reference date which corresponded to the conception date for women who had a first live birth either after a natural or a MAR conception, or the date of the last MAR treatment for women with no live birth by the end of 2017. We estimated linear probability models before and after the adjustment for socio-demographic characteristics. / Results: The results show that women who did not have a live birth after undergoing MAR treatments purchased more psychotropics than women who gave birth after conceiving naturally or through MAR, and that these differences did not attenuate over time. 12 years after the reference date 17.73% (95% CI: 16.82-18.63) of MAR- women purchased psychotropics, versus 11.11% of NC (95% CI: 10.98-11.26) and 12.17% (95% CI: 11.65-12.69) of MAR+ women. In addition, women who conceived naturally and through MAR had very similar psychotropic use patterns from three years before conception to four years after, and over the long term. Adjustment for women's socio-demographic characteristics did not change the results. / Conclusions: The similarities in psychotropic purchases of women who had a live birth, whether naturally or through MAR, suggest that the higher psychotropic 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.
| Type: | Article |
|---|---|
| Title: | Medically assisted reproduction and mental health: a 24-year longitudinal analysis using Finnish register data |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1016/j.ajog.2022.10.041 |
| Publisher version: | https://doi.org/10.1016/j.ajog.2022.10.041 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | fertility treatments; involuntary childlessness; mental health; psychotropic purchases; subfertility |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Education UCL > Provost and Vice Provost Offices > School of Education > UCL Institute of Education UCL > Provost and Vice Provost Offices > School of Education > UCL Institute of Education > IOE - Social Research Institute |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10159055 |
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