Right, there is no way so far to disentangle the depression effect from the effect of medication for the depression. Any person on antidepressants is still a person who needs them, so to speak. The underlying health factors are not treated by the antidepressant. At least, we can't assume they are.

Any study that I've ever seen that compared untreated depressed women and treated depressed women had the same outcomes: Similarly impaired fertility. Depressed women have lower fertility, treated or untreated.

The study you quote had a RR (relative risk) that included 1.0 (no effect at all) in its confidence interval, at the 90% level. To meet normal standards of 95%, the range is actually broader still. So, they didn't even use the standard signficance test, and they couldn't make the data show there was impairment.

The study is suggestive, at best. And, depression itself could be causing all the problems, all by itself.

Lar