It’s easy to see how infertility could lead to depression. So many personal hopes, life plans, and societal expectations are tied to family building. On top of that, assisted reproductive technologies (ARTs), if you have access to them, can be difficult and expensive.

What’s a little less clear is how depression can influence fertility. Yet, there is some evidence that it does.

This article explores both questions: how infertility and its treatment can cause depression and how depression and its treatment could hamper your attempts to get pregnant. It also offers some guidance for how to cope with both.

The relationship between depression and infertility is a two-way street. Research shows that infertility can lead to depression. And there’s some evidence to suggest that depression may influence fertility.

To be clear: Depression on its own doesn’t cause infertility.

However, according to a 2018 study, when a sperm-giving partner has severe depression, pregnancy rates drop slightly. Researchers think that may be because depression can make people less interested in sex. In addition, there’s some evidence that medications used to treat depression may affect your chances of having a healthy pregnancy.

Let’s take a closer look at how these two health conditions affect each other.

If you have had depression in the past, you are more likely to experience depression symptoms with infertility, according to 2020 research. Even if you have never experienced depression before, infertility can raise your risk for a number of reasons.

The stress of fertility concerns can lead to depression

The pressure to become pregnant can take a toll on your mental health — whether that pressure comes from family and friends, the wider society in which you live, or your own desires and expectations.

Research published in 2017 shows that, for many people, infertility affects identity. It may cause some people to question their worth or feel like their body is failing them. It can make you feel as though you’ve failed. And because of the stigma associated with infertility, it can be a profoundly isolating experience.

On top of that, the treatments themselves can cause stress. ARTs can be physically uncomfortable, expensive, time-consuming, and tiring. That extra stress can trigger depression, research shows.

In fact, studies show that a large percentage of people with infertility — between 25 and 60 percent — have depression symptoms.

Medication side effects could bring on depression symptoms

If you’ve developed depression after starting ART or in vitro fertilization (IVF), your symptoms could be related to the hormones in your treatment.

Researchers in 2020 looked at multiple studies of people with infertility and found that those whose treatment involved ovarian stimulation had more depression symptoms than people who didn’t take medication to stimulate their ovaries.

Some of the medications commonly used to treat infertility can cause depression symptoms, 2018 research says. These include:

  • clomiphene
  • leuprolide
  • gonadotropins

These side effects can build up as your treatment continues. Depression symptoms are especially likely to worsen if treatment doesn’t result in pregnancy.

You may have trouble sleeping

There’s a complicated interplay between fertility, sleep, and depression.

Researchers in 2022 suggested that many people experiencing infertility often have a hard time getting a good night’s rest. Disrupted sleep and sleep deprivation can also worsen fertility concerns.

For example, people with sleep trouble may have a harder time conceiving and may have a higher risk of losing a pregnancy early. More research needs to be done to understand why this link exists, though.

For many people, lack of sleep triggers or worsens depression symptoms like:

  • fatigue
  • excessive daytime sleepiness
  • headaches
  • irritability
  • trouble concentrating

Health conditions associated with infertility are also associated with depression

Some medical conditions can make it harder to get pregnant, according to 2019 research. Others are associated with a higher risk of pregnancy loss.

Sometimes it isn’t the condition itself that causes fertility challenges, 2017 research says — it’s the medications used to treat it.

In many cases, these health conditions also come with symptoms of depression, according to other research from 2017. Some of the conditions linked to lower fertility as well as depression are:

Depression doesn’t look the same for everyone. Typical symptoms include:

  • feelings of sadness, sorrow, or hopelessness
  • feelings of guilt and low self-worth
  • tiredness that doesn’t go away after a good night’s sleep
  • insomnia and other sleep disturbances
  • changes in your appetite or weight
  • trouble with digestion
  • body aches, headaches, and inflammation
  • mood changes, such as irritability or anger
  • loss of interest in sex and other activities you once liked to do
  • problems paying attention or remembering things
  • a feeling that you have no words to express yourself

Infertility and depression if you’re transgender

Puberty suppression, estrogen therapy, testosterone therapy, and some gender affirmation surgeries can lower fertility, 2019 research suggests. If you are considering your options for gender affirmation, it’s important to have good information about fertility preservation early in the process. Research from 2018 shows that talking about your fertility options before treatment, even if family building seems like a far-off possibility, can improve your overall sense of well-being later on.

Was this helpful?

The Centers for Disease Control and Prevention (CDC) defines infertility as not getting pregnant after 1 year of sex without birth control. Since fertility changes as you get older, many doctors will start treatment after 6 months for people over 35 years old or after two miscarriages.

The World Health Organization (WHO) reports that 15 percent of reproductive-age couples worldwide are affected by infertility.

Depression and fertility concerns are closely linked, but that doesn’t mean there’s nothing you can do about the symptoms you have. Here’s a quick rundown of common depression treatments to consider if you have fertility challenges.


Deciding whether to take antidepressants during fertility treatment isn’t easy. Even so, it’s important to talk with your healthcare professional about the risks and rewards involved. Different kinds of antidepressants work in different ways, so the risks vary from drug to drug.

Research on the safety of antidepressants is still ongoing. The most commonly prescribed class of antidepressants is selective serotonin reuptake inhibitors (SSRIs).

Some studies, such as one from 2020, have suggested that SSRIs may interfere with your ability to get pregnant.

A 2021 study found that sertraline, citalopram, and escitalopram had the lowest risk. Researchers in that study expressed concern about the safety of fluoxetine.

Some studies have found that non-SSRI and the SSRI antidepressant, fluoxetine may raise the risk of having an early pregnancy loss, but more research is needed. The risk appears to be small, but it’s worth considering.

Another consideration: A 2020 analysis of multiple studies showed that using some antidepressants early in pregnancy may raise the risk of a variety of birth defects, including problems with the heart.

It’s important to weigh these risks together with the risks to your own health if you don’t take antidepressant medications when you need them. Depression in pregnancy is associated with depression after giving birth, according to 2018 research.

And a 2019 research review suggests that postpartum depression may pose a risk to the health of the person who gave birth and the infant later on.

Mindful cognitive behavioral therapy (CBT)

CBT focuses on recognizing thoughts that aren’t accurate and reframing them so they don’t harm your mental health. In one study from 2020, women in IVF treatment who participated in mindfulness-based CBT had lower depression rates than those who didn’t.

In 8 of these 90-minute sessions, participants learned how to:

  • breathe, walk, and eat in a mindful way
  • detect their depression symptoms
  • change unhelpful behaviors, thoughts, and attitudes
  • use patterned breathing to increase calm
  • create a plan to use when depression symptoms increased

Personalized online therapy

If in-person therapy doesn’t work for you right now, you may want to try an online option. In one Dutch study from 2016, women using ART had access to online therapy early in their treatment. Not everyone opted to participate, but many of those who did had fewer anxiety and depression symptoms.

Self-care means different things to different people. Now is a good time to stop and think about what you need in order to get through this period of your life. Here are a few strategies to add to your emotional essentials toolkit.

Lean on your support network

Not everyone has a loving circle of family and friends to cheer them on the roller-coaster ride of infertility treatment. If you do, now is the time to leverage their support. Ask for what you need. Say yes to offers of help when you need it.

A 2021 study suggested that those with social support during fertility challenges have more self-compassion, self-efficacy, and life satisfaction than those without that support. Strong social support — including the support of your significant other and family — lowers psychological distress and depression symptoms, 2020 research says.

Even if you don’t have this support, don’t worry — the strategies below can give you other ways to express yourself and find help.

Find a safe place to talk about it

Feelings about fertility concerns and treatment can seem really private. But research from 2021 shows that people who share their feelings as they are going through fertility treatment tend to have less depression than those who do not.

Write down what you don’t feel comfortable saying out loud

In at least one study from 2017, a journaling method known as expressive writing effectively lowered depression symptoms in women with infertility.

Study participants spent 20 minutes privately writing about how their fertility challenges made them feel — especially those feelings they didn’t feel comfortable sharing with others. Writing out their feelings did not magically erase anxiety, but it did have a positive effect on depression, researchers said.

Try mindfulness meditations with breath and body scans

Many kinds of meditation are known to help with anxiety and depression. One that’s been proven to lower depression among women with fertility concerns is a method that involves listening to guided breathing and body scan meditations each day.

In one study from 2018, researchers said that women in groups who practiced these techniques had fewer symptoms of depression than those who wrote in gratitude journals.

Where to look for support

As isolating as infertility and depression can feel, you’re truly not in this alone. Here are some places where you can talk, listen to the experiences of others, and find the resources you need:

Was this helpful?

For many people, the physical and emotional challenges of infertility bring on depression. The good news is that depression is a treatable condition.

Medication, social support, therapy, proper sleep and nutrition, and other self-care strategies can help alleviate some depression symptoms. But it’s important to keep watch for signs that depression isn’t lifting or is getting worse, whether or not a pregnancy occurs.

Infertility and depression have a really complicated relationship. Fertility challenges and fertility treatments can leave you with a range of depression symptoms. Depression and antidepressants can sometimes affect your ability to have a healthy pregnancy.

Depression and fertility challenges can take a while to resolve, so it’s important to build up support around yourself as you’re moving through them. You’ll need a good relationship with a healthcare team, plus supportive friends and family members if you have them.

You may find therapy helpful, and mind-body self-care strategies may give you a sense of agency in a situation that often feels beyond your control.