Anxiety, depression and probability of live birth in a cohort of women with self-reported infertility in the HUNT 2 Study and Medical Birth Registry of Norway

Objective: The 'psychogenic' hypothesis has a long history in the field of infertility. The present study investigated whether anxiety or depressive symptoms are associated with probability of subsequent live birth in a cohort of infertile women from the general population. Methods: Using linked data from 12,987 women in the North-Trondelag Health Study 1995-97 (HUNT 2) and the Medical Birth Registry of Norway (MBRN) a cohort of 467 women with self-reported infertility was followed prospectively in the MBRN for 11 years with regard to live birth. Anxiety and depressive symptoms were measured at baseline in HUNT 2 by the Hospital Anxiety and Depression Scale (HADS), i.e. the Anxiety (HADS-A) and Depression (HADS-D) sub-scales. The relationship between anxiety or depressive symptoms and live birth in the MBRN was analysed using Cox proportional hazards regression analysis. Results: Anxiety and depressive symptoms were not associated with live birth rates. For anxiety symptoms, the crude hazard ratios (HR) for live birth was 1.004 (95% confidence interval (CI) = 0.96; 1.05); adjusted HR = 0.99 (95% CI = 0.94; 1.04), for depressive symptoms crude HR was 0.98 (95% CI = 0.92; 1.04); adjusted HR = 1.01 (95% CI = 0.94; 1.08). Among the 104 women with HADS-A >= 8 and/or HADS-D >= 8, 34 (32.7%) were registered with live birth in MBRN during the period of observation. However, 100 (27.6%) of the 363 women with both HADS-A <= 7 and HADS-D <= 7 were registered with live birth. Conclusion: Anxiety and depressive symptoms are not associated with probability of live birth in women with self-reported infertility in the general population.