Infertility depression

[want2bemum]

I am going to be starting IVF in a couple of months time (ICSI for male factor infertility) and have been feeling really down about it all.

I've been on and off antidepressants for many years anyway but this is making me worse, I have a lot of insomnia (hence being awake at 4/5am most mornings) and I just get up in the night and think about it all.

I'm off the antidepressants now because they switched me to Sertraline (meant to be better in pregnancy than the one I was taking) but it cause my periods to stop for 2 months, so I freaked out and stopped taking it. Periods back to normal now so I'm pretty sure it was the medication. I don't know if there are any others that are safe in pregnancy.

Anyone else in a similar boat? I'm worried this will impact the IVF if my mood is so low about it all. Just can't seem to pull myself out of it :(

@want2bemum I'm sorry to hear about how you're feeling. As far as I'm aware sertraline is usually the antidepressant used during infertility treatment, but if you think it affected your periods previously then you'll probably want to speak to your fertility specialist about it.

I think it's really difficult to know what to do, it's important to be in a good place mentally because fertility treatment will be an additional stress. But it's also important to make sure your specialist is happy with the treatment and that it is one where there is some indication of safety in pregnancy (always a patchy area in the evidence base).

Could you try melatonin for sleep by the way, this is often used in fertility treatment. I have no idea why the UK doesn't prescribe it more, it's so much better than sedative medications for insomnia. It won't stop the early morning waking but might assist if you have trouble getting to sleep at night.

I was also going to suggest melatonin. I developed insomnia after my 3rd round of IVF treatment and was given it to help. It also supposedly indirectly helps with egg quality as you’re getting a better nights sleep. I don’t think it will interfere with your other meds.

Hi, I'm sorry to hear you're feeling this way.

Although sertraline is considered the safest antidepressant for use in pregnancy, there are others that can be used if needed. The complexities of weighing up risks and benefits for each mean that it's usually a decision best made by secondary care rather than a GP, so if you aren't already under a specialist you could ask your GP for a referral to local specialist mental health services. As has already been mentioned, melatonin might also help - again, best discussed with a specialist in this situation.

Medication is also just part of how depression and related mental health problems can be treated. Non-pharmacological management is just as important. Some people find psychological therapy helpful, and a specialist can help you consider whether this would be suitable for you. You could also look at optimising your sleep hygiene and introducing relaxation activities to help you sleep better and manage stress. It can be helpful to look at your diet as well - if you're feeling anxious and on-edge, think about reducing caffeine; look to have a balanced diet to avoid sugar highs and crashes; etc. And exercise can be a great mood booster, particularly if you can get outdoors into a natural environment - you probably won't want to climb any mountains, but why not try walking, pilates, yoga, swimming (check whatever activity you choose is safe for pregnancy and discuss it with an instructor if appropriate).

Hi! I'm sorry to hear about how you're feeling. Maybe there is another combination or medication they can find that works better. Have you tried asking them about it?