Antidepressants and Male Fertility

Many people take antidepressants to help them manage their mental health, but could they impact male fertility? 

If you are taking antidepressants and hoping to become a father, it’s important to get informed about the impact they could have on your fertility. The most important thing is that you take to your doctor about your medication and your family building plans – as they will be able yo advise you. But to help you prepare for that conversation – here’s a brief overview of the research. 

Different Kinds of antidepressants 

Before we get stuck into the impact antidepressants could have on male fertility, it’s helpful to outline the different kinds of antidepressants that can be prescribed. They usually fall into two main categories. 

Selective serotonin reuptake inhibitors (SSRIs)

These are usually the first choice of antidepressants as they seem to have the least side effects. As well as depression, they have been shown to help other mental health conditions including Obsessive-Compulsive Disorder (OCD) and Post Traumatic Stress Disorder (PTSD)

Some of the most common SSRIs include:

• citalopram (Cipramil)
• dapoxetine (Priligy)
• escitalopram (Cipralex)
• fluoxetine (Prozac or Oxactin)
• fluvoxamine (Faverin)
• paroxetine (Seroxat)
• sertraline (Lustral)
• vortioxetine (Brintellix)

Serotonin and norepinephrine reuptake inhibitors (SNRIs)

SNRIs work very similarly to SSRIs but they are a newer class of drug and are used to treat major depression and other disorders including chronic pain. 

The common SNRIs include:

• venlafaxine  (Bonilux, Depefex, Foraven, Politid, Venlalic, Winfex, Efexor)
• duloxetine (Cymbalta, Yentreve)

You can then also have Serotonin antagonists and reuptake inhibitors (SARIs) – the main one of which is trazodone (Molipaxin) – which are not usually the first choice but might be prescribed if others haven’t worked, 

Then you also have Noradrenaline and specific serotonergic antidepressants (NASSAs) – the most common of which is mirtazapine (Zispin). They can be a good alternative for people who struggle with SSRIs and interestingly are thought to cause fewer sexual side effects! 

Can antidepressants impact male fertility?

Research in this area is still ongoing, but it’s an important conversation to have, especially as there is often still so much stigma around both mental health and infertility – taboos that need to be broken.

The vast majority of research into male fertility and antidepressants indicates that whilst there could be certain parameters impacted by taking these medications, the effects are short-term and reversible. There is still so much to be researched and confirmed but here’s what we know so far. 

Antidepressants and sperm motility

A 2015 study indicated that SSRI antidepressants could be associated with a decrease in sperm motility. However, the study did say that there was ‘insufficient data’ to suggest changing SSRIs prescriptions for men who are hoping to become fathers. Interestingly, a small 2021 study found that duloxetine (a common SNRI) had no impact on sperm motility, or any other sperm health parameters. Researchers suggested that this specific antidepressant could be a good alternative for men struggling with depression but keen to conceive. 

Antidepressants and sperm count

Some research has indicated that SSRIs may have a detrimental impact on sperm count. A 2019 scientific review found that these antidepressants seemed to reduce the quality of all sperm health parameters, including count and concentration. The same review concluded that SNRIs (specifically venlafaxine) didn’t have a significant impact on sperm count and in fact could potentially help to improve sperm morphology. 

Antidepressants and DNA fragmentation 

DNA Fragmentation is harder to test for and researchers are still unsure whether it’s an accurate indication of male fertility. However, some studies indicate that damaged sperm cells could find it harder to fertilise an egg, and could even be linked to miscarriage, so it’s worth thinking about. 

In terms of antidepressants and DNA Fragmentation, we don’t know too much right now. However, a 2010 study found that men taking Paxil – an SSRI also known as paroxetine – had more DNA Fragmentation after taking the drug for a month. Before taking Paxil, their average sperm DNA fragmentation level was 13.8%, but 4 weeks later, after taking Paxil every day, levels were more than double at 30.3%.

Antidepressants and erectile dysfunction 

Whilst there is still a lot more research needed into the impact of antidepressants and male fertility, we do know that they can trigger erectile dysfunction and other issues including loss of libido and delayed ejaculation.  Whilst these might not be linked to fertility specifically, obviously, anything that makes it difficult (or perhaps impossible) to have penetrative sex and climax could slash your chances of conceiving.

If you’re actively trying to have a baby it’s recommended that you have sex every day during the fertile window, so if you’re struggling to do that, you may struggle to conceive. Some antidepressants are more likely than others to cause issues in the bedroom, so speak to your doctor if you are concerned. 

If you are struggling with ED your doctor may prescribe your viagra to take alongside your antidepressants. But be careful, research shows that there could be a link between viagra and low sperm health. 

Should I come off antidepressants if I want to conceive?

Coming off antidepressants is a big decision and one that should not be made lightly. Whilst there’s a chance that coming off antidepressants could improve your sperm health, you have to measure that against the toll it could take on your mental wellbeing. 

If you are struggling to conceive, look into getting your sperm tested – our at-home test makes it easier than ever! Once you have your results, you can take a view on whether you need to alter your medication. Firstly, look at the other lifestyle factors that could be impacting your fertility – do you smoke? Are you overweight? Is your diet more junk food than vegetables? If the answer is yes then they might be more pressing things to address – and they could have benefits for both your fertility and your mental health. 

If you are still unhappy with the health of your swimmers, then consider sharing your concerns with your doctor. They may be able to suggest a different medication with fewer risks or advise you on a way you can safely come off your medications if that’s the route you decide to take.