Symptom Tracking in Assisted Reproductive Technologies (START)

This study is currently recruiting participants. (see Contacts and Locations)
Verified January 2015 by Massachusetts General Hospital
Information provided by (Responsible Party):
Marlene P. Freeman, MD, Massachusetts General Hospital Identifier:
First received: December 7, 2012
Last updated: January 13, 2015
Last verified: January 2015

This study assesses risk factors for depressive relapse in women undergoing fertility treatment with histories of major depressive disorder (MDD) or bipolar disorder. The study is focused on the acute risk factors of depressive relapse.

The investigators hypothesize that risk for depressive relapse will be greater among women who stop antidepressants compared to those who continue treatment with these agents.

Depression Relapse in Women Undergoing Fertility Treatment

Study Type: Observational
Study Design: Observational Model: Cohort
Time Perspective: Prospective
Official Title: Symptom Tracking in Women With a History of Depression Going Through Infertility Treatment.

Resource links provided by NLM:

Further study details as provided by Massachusetts General Hospital:

Primary Outcome Measures:
  • Depression relapse [ Time Frame: six months ] [ Designated as safety issue: No ]

Biospecimen Retention:   Samples With DNA

samples obtained with permission from participant and stored for future proteomic research

Estimated Enrollment: 60
Study Start Date: October 2012
Estimated Study Completion Date: August 2015
Estimated Primary Completion Date: July 2015 (Final data collection date for primary outcome measure)
Women currently taking antidepressants
Women who have selected to stay on antidepressant medication while undergoing infertility treatment.
Women not on antidepressants
Women who decided to discontinue their antidepressants while undergoing fertility treatments.

Detailed Description:

This study hopes to address the following aims:

Specific Aim #1: To delineate the relative risk of relapse in women undergoing IVF, IUI, or other infertility treatments who discontinue antidepressant therapy for depression, compared to those who maintain treatment with these agents.

Hypothesis: Risk for depressive relapse will be greater among women who stop antidepressants compared to those who continue treatment with these agents.

Specific Aim #2: To identify predictors of depressive relapse among women receiving IVF, IUI, or other infertility treatments

Hypothesis: Relapse rates will be greater among those who have: 1) histories of more recurrent depressive illness, 2) longer duration of attempt to conceive, and 3) a lower degree of perceived support from respective partners.

Specific Aim #3 (exploratory): To describe the trajectory of depressive symptoms in women with histories of depression across the course of IVF, IUI, or other treatments.

Hypothesis: Specific phases of the IVF cycle will have differential effects on the burden of depressive symptoms. Specifically, these phases include: 1) the phase prior to egg retrieval, 2) the phase after embryo transfer while a woman waits for the pregnancy test or her menstrual period, and 3) the phase after the experience of a negative pregnancy test (when applicable) following an IVF cycle. We seek to characterize factors associated both with vulnerability to more depressive symptoms and to resilience in the context of the different phases of IVF treatment.

Specific Aim #4 (exploratory): To identify biological markers of stress, including HPA axis dysregulation and inflammation associated with depressive relapse, during IVF, IUI, or other infertility treatments

Hypothesis: Hypothalamic-pituitary-adrenal (HPA) axis dysregulation, evidenced by increases in diurnal salivary cortisol patterns and markers of inflammation, will be associated with higher


Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Female
Accepts Healthy Volunteers:   Yes
Sampling Method:   Non-Probability Sample
Study Population

Subjects will include 60 women 18 years and older with histories of depression or bipolar disorder who are planning infertility treatment, specifically in utero insemination (IUI) or in vitro fertilization (IVF).


Inclusion Criteria:

  • Have a history of a MDE or bipolar disorder prior to starting fertility treatment.
  • Have received consultation around infertility treatment and plan to start fertility treatment.

Exclusion Criteria:

  • Use of corticosteroids within 1 month of enrollment.
  • Presence of any endocrine or autoimmune disorder, other than hypothyroidism well-treated for at least 6 months.
  • Current episode of depression or mania.
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its identifier: NCT01746797

Contact: Marlene F Freeman, MD 6176436403
Contact: Samantha P Marfurt, BS 6176439284

United States, Massachusetts
Massachusetts General Hospital Recruiting
Boston, Massachusetts, United States, 02114
Sub-Investigator: Lee S Cohen, MD         
Principal Investigator: Marlene F Freeman, MD         
Sponsors and Collaborators
Massachusetts General Hospital
Principal Investigator: Marlene F Freeman, MD Massachusetts General Hospital
Principal Investigator: Lee S Cohen, MD Massachusetts General Hospital
  More Information

No publications provided

Responsible Party: Marlene P. Freeman, MD, Director of Clinical Services at the Center for Women's Mental Health, Massachusetts General Hospital Identifier: NCT01746797     History of Changes
Other Study ID Numbers: 2012P001637
Study First Received: December 7, 2012
Last Updated: January 13, 2015
Health Authority: United States: Institutional Review Board

Keywords provided by Massachusetts General Hospital:
fertility treatment

Additional relevant MeSH terms:
Antidepressive Agents
Central Nervous System Agents
Pharmacologic Actions
Psychotropic Drugs
Therapeutic Uses processed this record on March 30, 2015