Abstract
OBJECTIVE: To examine the prevalence and predictors of major depressive disorder (MDD) for women and their partners during the course of fertility treatment. DESIGN: Prospective cohort study during an 18-month period. Participants completed interviews and questionnaires at baseline and at 4, 10, and 18 months of follow-up. SETTING: Five community and academic fertility practices. PATIENT(S): A total of 174 women and 144 of their male partners who did not have a successful child-related outcome during the time frame of the study. INTERVENTION(S): No interventions administered. MAIN OUTCOME MEASURE(S): The MDD was assessed using the Composite International Diagnostic Interview Major Depression module, a structured diagnostic interview. Additional variables were assessed with self-report questionnaire measures. RESULT(S): Of the women 39.1% and of the men 15.3% met the criteria for MDD during the 18-month course of the study. A binary logistic covariate-adjusted model showed that, for both women and men, past MDD was a significant predictor of MDD during treatment. Past MDD further predicted significant risk for MDD during treatment after controlling for other well-established risk factors (i.e., baseline levels of depression, anxiety, and partner support). CONCLUSION(S): The MDD was highly prevalent for fertility treatment patients and their partners. Past MDD predicted risk for MDD during treatment, and it contributed to MDD risk more than other commonly assessed risk factors. This suggests that patients and their partners would benefit from being routinely assessed for a history of MDD before the start of treatment to best direct psychosocial support and interventions to those most in need.