Sertraline and FET

[Yuliaaa]

Hi there,

I know it has been discussed before, but I could do with some opinions/advice/personal experience.
Due to my history of depression/anxiety and two failed transfers that took a toll on me, my psychiatrist wants me to start sertraline. I should slowly increase it to 100mg. At the same time, I am scheduled for a frozen transfer in about 3 weeks. My infertility doctor is not a huge fan of antidepressants and she advised me against it ( I had been on them before starting TTC).
I read that sertraline is mostly safe, but it interferes with progesterone levels. Also, this would be my third transfer and the only embryo I have left so I am scared I could mess things up by starting them at this point.

Any opinion would be appreciated!
❤

I would listen to the psychiatrist, sertraline is started at 50mg, so the fact your psychiatrist has advised to titrate it up to 100mg before you've even started it, tells me they feel you should be on it.

Sertraline would be my first choice for antidepressant treatment in IVF/pregnancy.

I think it's easy for a fertility specialist to say they would rather you don't take medication, but it's important for your mental health to be stable.

I'm not sure about the progesterone issues with it. If you're concerned ask for a progesterone level to be taken the day before the transfer.

I’m on 25mg since transfer. Small dose as i was actually weaning off it at the time. I’m close to birth now. It’s made me much less anxious this pg after many losses. Midwife and everyone else told me to stay on it. Safest ad in preg

If you take it, I recommend you advocate for yourself with your fertility doctor about monitoring serum P levels closely (probably closer than they usually would), taking levels two days before transfer and the day before at minimum to both see the level but also see that they are rising. P levels the day of transfer is useful info, but too late to call off the thaw, whereas the days leading up you can cancel the cycle if really need to (or adjust progesterone support accordingly if you are on it).

Sorry I actually remembered something “. The reason I was reducing was because I was on 50mg and it did affect my progesterone level meaning I had to delay my ivf cycle. At 25mg progesterone was fine. So yes there can be an affect on progesterone for some people. I did ask this similar question when I was about to cycle and lots of women said no effect but it did for me

Thank you all! I'll stay on the lowest dose possible and ask the clinic to monitor P2.

I think you've found the best possible solution OP. Keeping everything crossed for you

@dutchessmom thank you! 💗

A little update for who might be interested in this subject: My FET got cancelled because of lining issues however I tested P4 levels today on day 22 and I have just received the result: 73.1nmol. I have been on 25 mg of setraline since my previous post. I don't know what the levels would have been the day before let's say a 3d transfer or a 5d transfer, but day 21-22 levels are in normal range without aditional P suplementation.

And another update for whoever may be interested in the future. I had been on 100mg before my transfer last week and unfortunately it got cancelled due to low progesterone. It had been the first time my hormones were so messed up. Together with my psychiatrist we decided to stop sertraline completely and see what happens next cycle.

Sorry to hear cancelled- how low was the P if you don't mind me asking?

My consulant wants P4 to be above 1 ng/mL 5 days prior to the transfer. This time was 0.8 so we cancelled it. It was on a natural cycle btw. It had always been above 1 before.