Fluoxetine treatment for anxiety in women undergoing in vitro fertilization

Abstract Objective To compare anxiety levels experienced during 4 stressful periods of in vitro fertilization (IVF) and treatment outcomes between women taking fluoxetine and a placebo. Methods A prospective, randomized, double-blind, placebo-controlled trial of patients allocated to receive either fluoxetine (FLX) or folic acid (FA). Anxiety state was assessed at the beginning of ovarian stimulation (OS), ovum pick-up, embryo transfer, and on the day of the pregnancy test (DPT) using the State-Trait Anxiety Inventory (STAI). Results Baseline STAI-S and STAI-T were normal. From OS to DPT, STAI-S increased from 42.8 ± 10.6 to 44 ± 9.0 in the FLX group and from 40.9 ± 8.1 to 45.3 ± 8.3 in the FA group ( P = 0.03 and P = 0.001, respectively). IVF outcome was not affected by the treatment in the two groups. Conclusions Caution is needed in prescribing fluoxetine to alleviate anxiety in patients undergoing IVF. Studies are needed to determine whether other selective serotonin reuptake inhibitors or higher fluoxetine doses can relieve emotional distress without affecting IVF outcome.