Dawid Storman, Paweł Jemioło, Dominika Adamska, Zuzanna Sawiec
Epidemiology and Preventive MedicineDepartment of Hygiene and DieteticsFaculty of Medicine, Jagiellonian University Medical College, Krakow, Poland.
AGH University of Krakow, Krakow, Poland.
Reprod Biol Endocrinol. 2025 May 10;23(1):65. doi: 10.1186/s12958-025-01400-4.
One in six people experience infertility, often leading couples to seek Assisted Reproductive Technology (ART), which can be emotionally taxing. Anxiety and depression are common among individuals undergoing ART, highlighting the need for integrated mental health support, especially for women who face heightened risk of psychiatric disorders during their reproductive years. Despite the importance of psychiatric care, there is limited knowledge regarding the use of psychiatric medications among individuals undergoing ART.
Following a pre-written protocol (osf.io/egxw8/), we systematically searched electronic databases (Ovid MEDLINE, Embase, CENTRAL, Web of Science, PsycInfo, Scopus) up to 15.02.2025 to identify any study focused on psychopharmacotherapy among people undergoing ART. Two independent reviewers screened titles, abstracts, and full texts, performed data extraction, and resolved conflicts through discussion or consultation with a third reviewer. We synthesized data using descriptive analysis and performed analysis within the following subgroups: (1) group of medication according to Neuroscience-based Nomenclature (NbN) classes; (2) indication for using a specific medication (psychiatric / non-psychiatric).
We included 29 studies published in 31 papers. Psychiatric medications were primarily administered for the treatment of depression (n=12/29 studies, 41.38%) and anxiety disorders (n=8/29, 27.59%). Among all groups of medication serotonin reuptake inhibitors were the most commonly studied class of medications (n=15/29 studies, 51.72%), with fluoxetine being the most frequently used medication (n=8/29, 27.59%). Among medications for anxiety, GABA Positive Allosteric Modulators with midazolam occurred the most frequently (n=6/29, 20.69%). Medications for psychosis included single drugs: olanzapine, clozapine, risperidone, quetiapine, aripiprazole, haloperidol, and promethazine. Among medications that could be used in bipolar disorder there were: valproic acid, lithium, and lamotrigine. The most commonly reported endpoints in the studies were psychiatric symptom severity (n=11/29, 37.93%) and ART efficacy (n=10/29, 34.48%).
Evidence on the use of psychopharmacotherapy in ART primarily concerns women. Available literature indicates that psychopharmacotherapy for individuals undergoing ART frequently involves medications commonly used in general psychiatric practice, with a tendency toward lower dosing and a preference for serotonin reuptake inhibitors. However, this observation should be interpreted cautiously, as current evidence remains limited and further research is warranted to establish treatment patterns more conclusively. The variability in study designs and reporting standards further highlights the need for standardized methodologies and improved adherence to reporting guidelines to enhance the quality and applicability of future research.
Review registration number: osf.io/egxw8/.
六分之一的人经历过不孕不育，这常常导致夫妻寻求辅助生殖技术（ART），而这可能会带来情感负担。焦虑和抑郁在接受ART的人群中很常见，这凸显了综合心理健康支持的必要性，尤其是对于在生育年龄面临精神疾病风险更高的女性。尽管精神科护理很重要，但关于接受ART的人群使用精神科药物的知识有限。
按照预先编写的方案（osf.io/egxw8/），我们系统地检索了截至2025年2月15日的电子数据库（Ovid MEDLINE、Embase、CENTRAL、Web of Science、PsycInfo、Scopus），以识别任何关注接受ART人群的心理药物治疗的研究。两名独立的评审员筛选标题、摘要和全文，进行数据提取，并通过讨论或与第三位评审员协商解决冲突。我们使用描述性分析对数据进行综合，并在以下亚组中进行分析：（1）根据基于神经科学的命名法（NbN）分类的药物组；（2）使用特定药物的指征（精神科/非精神科）。
我们纳入了31篇论文中发表的29项研究。精神科药物主要用于治疗抑郁症（n = 12/29项研究，41.38%）和焦虑症（n = 8/29，27.59%）。在所有药物组中，5-羟色胺再摄取抑制剂是研究最频繁的药物类别（n = 15/29项研究，51.72%），氟西汀是最常用的药物（n = 8/29，27.59%）。在治疗焦虑的药物中，咪达唑仑作为GABA正向变构调节剂出现的频率最高（n = 6/29，20.69%）。治疗精神病的药物包括单一药物：奥氮平、氯氮平、利培酮、喹硫平、阿立哌唑、氟哌啶醇和异丙嗪。可用于双相情感障碍的药物有：丙戊酸、锂盐和拉莫三嗪。研究中最常报告的终点是精神症状严重程度（n = 11/29，37.93%）和ART疗效（n = 10/29，34.48%）。
ART中使用心理药物治疗的证据主要涉及女性。现有文献表明，接受ART的人群的心理药物治疗通常涉及一般精神科实践中常用的药物，给药剂量有降低的趋势，且更倾向于5-羟色胺再摄取抑制剂。然而，这一观察结果应谨慎解读，因为目前的证据仍然有限，需要进一步研究以更确凿地确定治疗模式。研究设计和报告标准的差异进一步凸显了标准化方法的必要性以及提高对报告指南的依从性，以提高未来研究的质量和适用性。
综述注册号：osf.io/egxw8/。
