Does antidepressant use affect ART outcomes?

A recent Danish nationwide register-based cohort study, published online in Fertility and Sterility, looked at a question that often feels clinically important but is not always easy to answer with confidence: does antidepressant use around the time of embryo transfer affect IVF treatment outcomes? 

The study included 44,542 women who underwent fertility treatment between 2006 and 2019, covering a total of 123,146 embryo transfers. Researchers compared three groups: women who were taking antidepressants at the time of embryo transfer, women who had recently discontinued treatment, and women with no history of antidepressant use.

The main finding was relatively clear. After adjustment for confounders, neither current nor recent antidepressant use was associated with a lower chance of clinical pregnancy or live birth. This may feel somewhat counterintuitive at first, since antidepressant use is often assumed to signal a poorer overall prognosis. But in this large, real-world dataset, antidepressant use alone did not appear to meaningfully reduce treatment success.

What makes this study especially relevant is not only its scale, but also the kind of question it addresses. In IVF practice, questions around psychiatric treatment often sit at the intersection of medical outcomes, patient anxiety, and counseling uncertainty. Findings like these may offer some reassurance that antidepressant use, on its own, should not automatically be viewed as a negative prognostic factor when discussing embryo transfer outcomes.

At the same time, the study should be interpreted with appropriate caution. This was an observational study, not a randomized trial, and the exposed groups were described as reflecting women with mild to moderate depression. In other words, the findings are useful, but they do not remove the need for individualized judgment. In practice, medication use still needs to be considered alongside each patient’s broader clinical and psychological context.