Associations between assisted reproductive technologies and women’s mental health: an investigation using clinical data linkage

Lay summary

In the UK, approximately 20,000 children are born through Assisted Reproductive Technologies (ART) each year, a figure likely to rise. Engaging in ART is inevitably stressful, with many expectations, and disappointments. We know that infertility induces considerable life stress and can include societal repercussions and personal suffering. Despite isolated reports, remarkably little is known about the influence of ART on the mental health of the mother.

This study will be the first to examine the burden of mental health problems associated with ART pregnancies in the UK by using records from both the HFEA and records from the South London and Maudsley NHS Foundation Trust (SLaM) via the Clinical Records Informatics System (CRIS).

To answer this question, the Clinical Data Linkage Service (CDLS) at SLaM has linked the HFEA database to CRIS and currently holds anonymised HFEA data for female patients of the South London and Maudsley NHS Foundation Trust who have also undergone fertility treatment within the UK. It is believed that it will be the first undertaking of its kind to demonstrate the use of routinely collected mental health and fertility treatment data in order to understand the two-way relationships between infertility/fertility treatments and the treatment/outcome of mental health disorders. By undertaking this linkage, and subsequent research projects, it will provide a strong evidence-base to improve understanding of people’s risks and experiences, informing service improvement, and guiding targeted intervention to improve outcomes and experiences of women undertaking fertility treatments.

Public benefit statement

Findings from the study have the potential to rapidly inform local/national health and fertility treatment developments, especially given the size of the sample and the clinical detail available. The fact that information has been collected longitudinally over many years will provide the opportunity to study the impact of ART on individual health-related outcomes. Result summaries will be fed back to relevant organizations such as NICE and the HFEA and promoted locally with the aim of directly impacting NHS policies and current patient care. Alongside the service user groups consulted in this project, the proposed linkage is expected significantly increase high quality research outputs that examine the interface between mental health and fertility treatments. Ultimately, this will provide much needed evidence to direct fertility treatment initiatives.

Data linkages

Mental health records from the Clinical Record Interactive Search (CRIS) system at the South London and Maudsley (SLaM) NHS Foundation Trust. The CRIS system also contains linkages to General Practice data in Lambeth from the Lambeth DataNet (The Hospital Episode Statistics (HES)) as well as some maternity and neonatal data records from Guys and St.Thomas, and King’s College Hospital NHS Foundation Trusts in London.