IVF and depression

[Anonymous]

My husband and I have been trying to conceive a second child (first with Clomid, then with Follistem and Microdose leupron) for the past year. One miscarriage, one chemical pregnancy. I'm 42. We are going to try IVF this month, but I'm concerned about my doctor's comments that the "roller-coaster" hormonal effects of the drugs is much worse with IVF, because I will be getting the drugs in much higher doses. I have a history of severe depression (been on Zoloft for 10+ years) and had a terrible episode of PPD after my first child's birth. My question: has anyone out there who suffers from depression ever experienced a bad episode while doing IVF? I just want to know what to expect and whether I should make a plan with my shrink.

Thanks in advance!

[Anonymous]

Making a plan w/your shrink, yourself & your partner is not a bad idea, however, you may not need it....I have along history of Depression (meds, hospitalizations, bad PPD, the works) & have done IUI's & IVF's. (years of unsuccesful IUI's, but then 2 successful IVF's & am currently pregnant). Although the stress of infertility itself, treatments & uncertainties add to stress levels in general (as you have already experienced, I'm sure), it was not my experience that the actual IVF meds themselves contributed to a Depression or worsened my mood. Staying on Zoloft during IVF & even during pregnancy would not be the worst thing in the world for you either. Although my 1st pregnancy I was able to stay off antidepressants, I had horrible PPD, and this time, I realized I need to be on Wellbutrin during the pregnancy itself & it has made pregnancy much more enjoyable. I wish you the best of luck & I think the most important thing (at least for me) was to be honest w/myself, my shrink, & my partner about when I needed help.

[Anonymous]

OP here: Thank you for the response! It was very helpful.

[Anonymous]

I second the recommendation to make a plan in advance with your psychiatrist.

My experience---

I had a few episodes of very low grade depression in my early and late 20's. All resolved with either no medication or with less than 6 months of an SSRI.
I was never suicidal.

Did IVF, got pregnant with twins, had a super rough pregnancy (strict bed rest for 4 months, multiple hospitalizations for pre-term labor), had a traumatic emergency c/s delivery. Despite the complications of pregnancy, I was never depressed during pregnancy. In fact, my mood was quite good. However, after delivery I started having panic attacks in the hospital (which I had NEVER had before) and ended up quickly spiraling into a MAJOR depression. Was actively suicidal for weeks. I ended up taking a succession of anti-depressants and finally fully came out of this depression after 18 months.

Had frozen embryos so I did a FET when the twins were about 2.5. Unsuccessful. Ended up sliding into a depression which I think was caused primarily from the withdrawal of the medications (estrogen and progesterone). Yes, I was sad that I didn't get pregnant but this was something more than just reactionary sadness. I started on an SSRI again and I was feeling better within a month or so. I continued on the SSRIs for about 6 months.

Finally, when the twins were 3.5 I did another fresh cycle and got pregnant with one baby. I'm now 6 months and have been actively seeing a psychiatrist during this pregnancy. I'm not on medication now but my plan is to start on medication around 34 weeks of pregnancy and to have extremely close followup after delivery. I hope and pray that all goes well. I frequently wonder if this was the right situation to voluntarily get myself in to.



My experience with IVF drugs (lupron and stims) is that I feel just fine when I'm on them. It's the drop in estrogen/progesterone which happens after a failed cycle or the birth of a baby that really seems to trigger the depression. Also, I found that having twins was another risk factor for major depression. There was recent study which showed that women who birth twins are 40% more likely to suffer from major depression following the birth than moms of a singleton. This was true even if the mom of twins had multiple singleton births prior to their twins. There is likely something about the extra hormonal shift that occurs during the pregnancy (and mainly after pregnancy) of multiples that contributes to post partum depression (plus the added sleep deprivation, chaos, etc. certainly doesn't help). Going into IVF a second time, I did everything possible to avoid multiples (and put back a single embryo).

In any case, that is my experience. I hope that you are successful in navigating this all!

[Anonymous]

i would recommend having your psychiatrist discuss your history with your RE. just so everyone is on the same page. talk therapy is also very helpful.

[Anonymous]

Thanks very much to everyone for their comments. Particularly helpful is knowing that the drop in hormone levels had triggered some problems for one poster (that is my main concern; it's also what played a major role in my PPD). I will definitely work closely with my psychiatrist as I start this process to make sure I'm ready for any bad episodes.

Thanks again!!