Williams Katherine E, Marsh Wendy K, Rasgon Natalie L
Stanford Center for Neuroscience in Women's Health, Department of Psychiatry and Behavioural Sciences, Stanford University and Hospitals, Stanford, CA 94305, USA.
Hum Reprod Update. 2007 Nov-Dec;13(6):607-16. doi: 10.1093/humupd/dmm019. Epub 2007 Sep 25.
A medline literature review of fertility and mood disorder articles published since 1980 was performed in order to critically review the literature regarding a relationship between mood disorders, fertility and infertility treatment. Previous studies suggests that mood disorders, both in the bipolar and unipolar spectrum, may be associated with decreased fertility rates. Most studies report that women seeking treatment for infertility have an increased rate of depressive symptoms and possibly major depression (none showed evaluated mood elevations). Many, but not all, studies found that depressive symptoms may decrease the success rate of fertility treatment. Treatments for infertility may independently influence mood through their effects on estrogen and progesterone, which have been shown to influence mood through their actions on serotonin. Studies are limited in scope and confounding variables are many, limiting the strength of the results. In conclusion, a range of existing studies suggests that fertility and mood disorders are related in a complex way. Future studies should use clinical interviews and standardized and validated measures to confirm the diagnosis of mood disorders and control for the variables of medication treatment, desire for children, frequency of sexual intercourse, age, FSH levels, menstrual cycle regularity in assessing an interrelationship between mood disorders and fertility.
为了批判性地回顾关于情绪障碍、生育能力和不孕治疗之间关系的文献，我们对自1980年以来发表的有关生育与情绪障碍的文章进行了医学文献数据库检索。先前的研究表明，双相和单相谱系中的情绪障碍可能与生育率下降有关。大多数研究报告称，寻求不孕治疗的女性抑郁症状发生率增加，可能还伴有重度抑郁症（没有研究评估情绪高涨情况）。许多（但并非所有）研究发现，抑郁症状可能会降低生育治疗的成功率。不孕治疗可能通过其对雌激素和孕激素的影响独立影响情绪，而雌激素和孕激素已被证明通过对血清素的作用来影响情绪。研究范围有限且混杂变量众多，限制了研究结果的说服力。总之，一系列现有研究表明，生育能力与情绪障碍以复杂的方式相关。未来的研究应采用临床访谈以及标准化和经过验证的测量方法，以确认情绪障碍的诊断，并在评估情绪障碍与生育能力之间的相互关系时控制药物治疗、生育意愿、性交频率、年龄、促卵泡生成素水平、月经周期规律性等变量。
