Boston IVF, Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Harvard Medical School, 130 Second Avenue, Waltham, MA 02451, USA.
Hum Reprod. 2013 Jan;28(1):160-71. doi: 10.1093/humrep/des383. Epub 2012 Oct 31.
What is the current literature on the safety and efficacy of selective serotonin reuptake inhibitor (SSRI) use in infertile women?
There is little evidence that infertile women benefit from taking an SSRI, therefore they should be counseled appropriately about the risks and be advised to consider alternate safer treatments to treat depressive symptoms.
SSRI use is associated with possible reduced infertility treatment efficacy as well as higher rates of pregnancy loss, preterm birth, pregnancy complications, neonatal issues and long-term neurobehavioral abnormalities in offspring.
STUDY DESIGN, SIZE, DURATION: Review of existing literature.
PARTICIPANTS/MATERIALS, SETTING, METHODS: We conducted a review of all published studies that evaluate females with depressive symptoms who are taking antidepressant medications and who are experiencing infertility.
Antidepressant use during pregnancy is associated with increased risks of miscarriage, birth defects, preterm birth, newborn behavioral syndrome, persistent pulmonary hypertension of the newborn and possible longer term neurobehavioral effects. There is no evidence of improved pregnancy outcomes with antidepressant use. There is some evidence that psychotherapy, including cognitive-behavioral therapy as well as physical exercise, is associated with significant decreases in depressive symptoms in the general population; research indicates that some forms of counseling are effective in treating depressive symptoms in infertile women.
LIMITATIONS, REASONS FOR CAUTION: Our findings are limited by the availability of published studies in the field, which are often retrospective and of small size.
Practitioners who care for infertility patients should have a thorough understanding of the published literature so that they can adequately counsel their patients.
STUDY FUNDING/COMPETING INTEREST(S): None.
目前关于选择性 5-羟色胺再摄取抑制剂（SSRIs）在不孕女性中的安全性和疗效的文献有哪些？
目前几乎没有证据表明服用 SSRIs 会使不孕女性受益，因此应适当告知她们相关风险，并建议她们考虑其他更安全的治疗方法来治疗抑郁症状。
SSRIs 的使用可能会降低不孕治疗的效果，增加流产、早产、妊娠并发症、新生儿问题和后代长期神经行为异常的风险。
研究设计、规模、持续时间：对现有文献的综述。
参与者/材料、设置、方法：我们对所有评估有抑郁症状且正在服用抗抑郁药物的不孕女性的研究进行了综述。
怀孕期间使用抗抑郁药与流产、出生缺陷、早产、新生儿行为综合征、新生儿持续性肺动脉高压以及可能的长期神经行为影响的风险增加有关。没有证据表明使用抗抑郁药可以改善妊娠结局。有一些证据表明，心理疗法，包括认知行为疗法和体育锻炼，与一般人群中抑郁症状的显著减少有关；研究表明，某些形式的咨询对治疗不孕女性的抑郁症状是有效的。
局限性、谨慎的原因：我们的发现受到该领域已发表研究的可用性的限制，这些研究通常是回顾性的且规模较小。
关注不孕患者的从业者应该充分了解已发表的文献，以便能够充分为患者提供咨询。
研究资金/利益冲突：无。
