diagnosis guide
If you’ve just received a medical diagnosis, or you’re concerned that something in your present or past health history might be jeopardizing your fertility, check here for quick info on common medical conditions and how they can affect conception and pregnancy.
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Depression
What It Is
Depression is a serious medical illness involving the brain; the condition causes intense, persistent feelings of sadness and hopelessness that interfere with daily life.
Who Gets It
About 20 million Americans suffer from depression. It is twice as common among women as men, according to the National Institute of Mental Health.
Symptoms
Symptoms include sadness, loss of interest or pleasure in activities that used to be enjoyed, change in weight, difficulty sleeping or oversleeping, energy loss, feelings of worthlessness, and thoughts of death or suicide.
How It's Diagnosed/Detected
The doctor will usually conduct a physical examination and lab tests to rule out another medical reason for depressive symptoms. A psychological evaluation based on detailed information about symptoms – their severity, duration, and effects on daily life – helps confirm the diagnosis.
How It Affects Fertility (And Pregnancy)
Because the brain regulates hormones that affect the reproductive organs, struggling with stress or depression while trying to conceive can throw up roadblocks. Various drugs used to treat depression also can affect fertility in both men and women.
Treatment
Most people respond best to a combination of medication and psychotherapy. Dozens of medications are available to treat depression. For many doctors, the first choices are drugs known as selective serotonin reuptake inhibitors (SSRIs), a category that includes such well-known brands as Prozac, Paxil, Zoloft, and Celexa. If none of the SSRIs work, the doctor may prescribe older drugs known as tricyclic antidepressants or, as a last resort, monoamine oxidase inhibitors (MAOIs), both of which can have severe side effects.
Fertility Prognosis
If you’re having trouble handling everyday life and think you might be depressed, talk to your doctor or a mental health professional to find the best course of treatment. If you or your partner are being treated for depression or anxiety or have struggled with mood disorders in the past, you also should seek medical advice before trying to conceive. Tricyclic antidepressants, such as Elavil, may increase levels of the hormone prolactin in women, which can block ovulation. In men, SSRIs often affect libido and the ability to get an erection or ejaculate, and new evidence suggests that these drugs may also cause hormonal changes that damage sperm. It’s important to let your prescribing doctor know when you plan to start trying to conceive, as it may be necessary to switch you (or your partner) to a different medication, change your dose, or come up with an alternate treatment plan.
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