Assisted reproductive technology (ART) treatment in women with schizophrenia or related psychotic disorder: a national cohort study.
OBJECTIVE
To determine the prevalence rate of women with a diagnosis of schizophrenia or related psychotic disorder in assisted reproductive technology (ART) treatment and to study these women's fertility treatment outcome in comparison to women with no psychotic disorders.


METHODS
We used a national register-based cohort of 42,915 Danish women in ART treatment from 1.1.1994 to 30.9.2009. All women with a diagnosis of schizophrenia or related psychotic disorders before, during or after their ART treatment were identified by individual-level linkage of nationwide registers of ART treatment, psychiatric admission, birth and socio-demographic status. The comparison group (N=42,671) consisted of all women in the study cohort never diagnosed with psychotic disorders. Conventional descriptive methods were used for the statistical analyses.


RESULTS
Two hundred and forty-four (0.6%) women in the study cohort received a diagnosis of psychotic disorder before (N=135-55.3%), during (N=7-2.9%) or after (N=102-41.8%) ART treatment. The mean time from last diagnosis of psychotic disorder to their first ART treatment in the 135 women with a psychiatric diagnosis prior to their first ART treatment was 7.1 ± 5.6 years (25-75% percentile: ±2.8-10.4 years). The most frequent diagnoses were acute and transient psychotic disorder. Women with a diagnosis of schizophrenia or related psychotic disorder before their first ART treatment had a lower ART treatment success rate as significantly fewer women obtained a live birth (40.0% vs. 51.9%, P<0.01). However, we found no statistical differences in perinatal outcomes for the children born by women in the study population and comparison group.


CONCLUSIONS
The prevalence of women with a psychotic diagnosis in fertility treatment is lower than the prevalence in the general population. Women with a psychotic disorder prior to ART treatment have a lower fertility treatment success rate compared to women without psychotic disorder. Women with a psychotic disorder achieving delivery show similar obstetric outcomes to women with no psychotic disorder.
Department of Public Health, University of Copenhagen, 5 Øster Farimagsgade, P.O. Box 2099, DK-1014 Copenhagen K, Denmark. Electronic address: nebdrup@gmail.com.
Ninna H
NH
Ebdrup
Department of Public Health, University of Copenhagen, 5 Øster Farimagsgade, P.O. Box 2099, DK-1014 Copenhagen K, Denmark.
Maria
M
Assens
Department of Public Health, University of Copenhagen, 5 Øster Farimagsgade, P.O. Box 2099, DK-1014 Copenhagen K, Denmark.
Charlotte O
CO
Hougaard
Department of Obstetrics and Gynecology, Copenhagen University Hospital, Hvidovre Hospital, 30 Kettegårds Allé, DK-2650 Hvidovre, Denmark.
Anja
A
Pinborg
Psychiatric Center Copenhagen, Copenhagen University Hospital, Rigshospitalet, 9 Blegdamsvej, DK-2100 Copenhagen Ø, Denmark.
Ida
I
Hageman
Department of Public Health, University of Copenhagen, 5 Øster Farimagsgade, P.O. Box 2099, DK-1014 Copenhagen K, Denmark.
Lone
L
Schmidt
D000328:Adult; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006801:Humans; D007246:Infertility / Q000150:complications / Q000628:therapy*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000523:psychology; D018873:Pregnancy Rate; D015995:Prevalence; D012042:Registries; D027724:Reproductive Techniques, Assisted / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012559:Schizophrenia / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D013997:Time Factors; D055815:Young Adult
Assisted reproductive technology; Maternal psychosis; Obstetric outcome; Register-based cohort study; Schizophrenia