Do antidepressants affect male fertility?

Question

Do antidepressants affect male fertility?

Answer

Around 12% of Australians aged between 18 to 47 take antidepressants^[1]. Many people in this age group will be hoping to have children and might wonder about the effects of antidepressants on their fertility.

Selective serotonin reuptake inhibitors (SSRIs) are the most commonly used antidepressants. Because this class of drugs is so common, we know more about SSRI effects on fertility than other types of antidepressant medications.

SSRIs certainly affect male sexual function. They increase the time taken to reach orgasm (they are used to treat some men with premature ejaculation) and can inhibit orgasm completely on some, but not all, occasions.

When it comes to male fertility, SSRIs can reduce sperm count, inhibit sperm motility (movement) and damage the genetic material (DNA) in the sperm^[2],[3]. Low sperm counts, poor motility and DNA breakage can reduce male fertility but whether SSRIs influence couples’ ability to get pregnant is not known^[4],[5]. It’s reassuring that the effects of SSRIs on sperm are reversed if SSRIs are no longer taken2.

For infertile couples using IVF or other types of assisted reproductive techniques, pregnancy success might be lower if the male partner has depression^[6]. Whether SSRIs affect the fertility of men in this situation is unknown.

You shouldn’t stop taking medication without advice from a health professional. Talking with your GP, psychiatrist, psychologist and/or fertility specialist will help you decide whether you should keep taking your antidepressants and how to manage your mental health if you and your partner are trying to conceive.

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Understanding men's mental health and why yours might be suffering

A/Prof Tim Moss

Associate Professor Tim Moss has PhD in physiology and more than 20 years’ experience as a biomedical research scientist. Tim stepped away from his successful academic career at the end of 2019, to apply his skills in turning complicated scientific and medical knowledge into information that all people can use to improve their health and wellbeing. Tim has written for crikey.com and Scientific American’s Observations blog, which is far more interesting than his authorship of over 150 academic publications. He has studied science communication at the Alan Alda Centre for Communicating Science in New York, and at the Department of Biological Engineering Communication Lab at MIT in Boston.

References

_{[1] https://www.psychwatchaustralia.com/post/1-in-8-over-3-million-australians-are-on-antidepressants-why-is-the-lucky-country-so-miserable}

_{[2] Beeder & Samplaski, 2020. Effect of antidepressant medications on semen parameters and male fertility. International Journal of Urology}

_{[3] Drobnis & Nangia, 2017. Psychotropics and Male Reproduction, in: Advances in Experimental Medicine and Biology}

_{[4] Sylvester et al., 2019. Selective Serotonin Reuptake Inhibitors and Fertility: Considerations for Couples Trying to Conceive. Harvard Review of Psychiatry.}

_{[5] Amano, 2020. Editorial Comment to Effect of antidepressant medications on semen parameters and male fertility. International Journal of Urologu}

_{[6] Evans-Hoeker et al,. 2018. Major depression, antidepressant use, and male and female fertility. Fertility and Sterility}

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