Andrew M Siegel1, Vardit Ravitsky2. 1. University of Pennsylvania Perelman School of Medicine, 3535 Market Street, 2nd Fl, Philadelphia, PA, 19104, USA. asiege@upenn.edu. 2. School of Public Health, University of Montreal, Montreal, Canada.
Abstract
PURPOSE OF REVIEW: This review aims to provide guidance to clinicians facing requests for assisted reproduction from women with mental illness. RECENT FINDINGS: The paper explores the clinical and safety aspects of initiating fertility treatment in this context, including the use of psychotropic medication and the risk of untreated psychiatric mood or psychotic disorders. It also presents the ethical considerations involved in candidate selection, including treating similar cases equitably to avoid biased decisions based solely on "gut-feelings," respect for women's reproductive autonomy, and an effort to protect patients and prospective fetuses/children from harm by employing optimal strategies regarding medication and psychosocial support. Clinicians ought to be informed regarding recent evidence related to the safety and efficacy of psychopharmacologic treatment of women during pregnancy and the post-partum. They should also carry out a thoughtful ethical analysis to ensure minimal violation of women's reproductive autonomy.
PURPOSE OF REVIEW: This review aims to provide guidance to clinicians facing requests for assisted reproduction from women with mental illness. RECENT FINDINGS: The paper explores the clinical and safety aspects of initiating fertility treatment in this context, including the use of psychotropic medication and the risk of untreated psychiatric mood or psychotic disorders. It also presents the ethical considerations involved in candidate selection, including treating similar cases equitably to avoid biased decisions based solely on "gut-feelings," respect for women's reproductive autonomy, and an effort to protect patients and prospective fetuses/children from harm by employing optimal strategies regarding medication and psychosocial support. Clinicians ought to be informed regarding recent evidence related to the safety and efficacy of psychopharmacologic treatment of women during pregnancy and the post-partum. They should also carry out a thoughtful ethical analysis to ensure minimal violation of women's reproductive autonomy.
Authors: Christina D Chambers; Sonia Hernandez-Diaz; Linda J Van Marter; Martha M Werler; Carol Louik; Kenneth Lyons Jones; Allen A Mitchell Journal: N Engl J Med Date: 2006-02-09 Impact factor: 91.245