4. Discussion
bleeding, major depression, ovarian follicles decreases, gastrointestinal bleeding, PCOS, infertility, psychiatric, sexual dysfunction, MDD, depression
BLEEDING, LEIOMYOMA, GASTROINTESTINAL BLEEDING, DISORDERS, ENDOMETRIOMA
In the current study, we aimed to evaluate whether SSRI group antidepressants, which are widely used in the treatment of depression, adversely affect OR in women of reproductive age. Our main findings were that LH levels were significantly lower in the MDD group, menstrual duration and bleeding were significantly higher in the control group, FSH and E2 levels were significantly higher, and AMH and total AFC measurements were significantly lower in the MDD group after SSRI treatment compared to pretreatment.Inhibin B and AMH are glycoprotein hormones produced by small ovarian follicles. Inhibin B is primarily secreted by preantral follicles, whereas AMH is secreted by primary, preantral, and early antral follicles. As the number of ovarian follicles decreases with age, so do AMH and early-follicular-phase inhibin B concentrations. Reduced inhibin B secretion reduces the level of central negative feedback, which leads to increased pituitary FSH secretion and higher late-luteal and early-follicular FSH concentrations (an indirect measure). In turn, the earlier increase in FSH levels stimulates an earlier onset of new follicular growth and an increase in E2 concentrations, ultimately shortening the follicular phase and the overall cycle. These hormone tests are, therefore, used as markers of ovarian reserve [Multiple studies [Because of their consistent efficacy and favorable safety profile, SSRIs are now widely used in the treatment of a variety of psychiatric disorders. These drugs, however, can have serious side effects such as gastrointestinal bleeding and sexual dysfunction [Some limitations of the present study should be considered. The following study limitations were identified: (1) this was a single-center study; (2) a group with a diagnosis of infertility was not included; (3) a group of patients with untreated major depression was not included; (4) a group with irregular menstrual cycles after SSRI treatment was not included; (5) cases with leiomyoma, endometrioma, and PCOS were not evaluated; and (6) cases were assessed after only six months. 