Embryo aneuploidy is not impacted by selective serotonin reuptake inhibitor exposure

Objective To study whether maternal exposure to selective serotonin reuptake inhibitors (SSRIs) has any influence on rates of blastocyst aneuploidy and/or in vitro fertilization (IVF) cycle outcomes. Design Retrospective cohort analysis. Setting Private and academic IVF center. Patient(s) Patients who underwent IVF with preimplantation genetic treatment with trophectoderm biopsy (n = 4,355 cycles) and patients who underwent a single-embryo transfer (SET) between January-2012 and June-2017 (n = 2,132 cycles). Intervention(s) Comprehensive chromosome screening and euploid SET. Main Outcome Measure(s) Odds of embryo aneuploidy. Result(s) Of 19,464 embryos analyzed, 3.9% (n = 743) were exposed to a SSRI, and the remaining 96.1% (n = 18,721) were not. The embryo euploid rate was 52.1%, and the aneuploid rate was 42.5%; 5.4% of the reports were inconclusive. No differences were found in clinical and IVF characteristics among the cohorts. After controlling for cofounders, there was no statistically significant associations between exposure to SSRIs and the odds of aneuploidy (adjusted odds ratio [OR] 0.04; 95% confidence interval [CI], −0.04–0.09). In a subanalysis including 2,132 thawed SET cycles, no differences were observed in implantation rate (71.3% vs. 70.1%; OR 0.60; 95% CI, 0.60–1.47), clinical pregnancy rate (58.2% vs. 59.7%; OR 0.70; 95% CI, 0.70–1.61), loss rate (18.5% vs. 11.49%; OR 1.54; 95% CI, 0.94–2.54), or multiple pregnancy rate (0.6% vs. 0; OR 0.7; 95% CI, 0.02–7.32) between cohorts. Conclusion(s) Patients exposed to SSRIs in vivo are not susceptible to an increased rate of embryo aneuploidy in IVF. The IVF outcomes of patients exposed to SSRIs do not differ from those of unexposed patients.