Do Antidepressants Affect Female & Male Fertility?
Depression is a common mental health condition that affects millions of women and men worldwide and if you’re struggling to conceive and you’re feeling more stressed as time goes by - you have higher chances of becoming depressed. Selective Serotonin Reuptake Inhibitors (SSRIs) are a class of antidepressant medications commonly prescribed to treat depression, anxiety disorders, and other mental health conditions. Some of the common brands include Zoloft and Lexapro. These medications work by increasing the levels of serotonin in the brain, a neurotransmitter that regulates mood, sleep, and appetite. While SSRIs are generally safe and effective for most people, there is some evidence suggesting that antidepressants may have an effect on male and female fertility. Let’s take a look at common antidepressant medications such as Zoloft and fluoxetine and typical side effects in women and partners trying to conceive.
Do Antidepressants Affect Female Fertility?
Effects of Antidepressants on Female Infertility: Ladies, if you're on SSRIs for more than six months, there may be a higher risk of infertility. In other words, those antidepressants might be taking away your baby-making abilities. So, if you're not looking to start a family anytime soon, feel free to pop those pills. But if you're hoping to hear the pitter-patter of little feet, you may want to talk to your doctor about other options. Grigoriadis et al. (2013) also found that the longer the longer the duration of SSRI use, the greater the risk of infertility.
Does Prozac Affect Fertility?
Pandey et al. (2014) investigated the impact of fluoxetine (Prozac) on ovarian function. They found that fluoxetine caused a significant reduction in the size of ovarian follicles and inhibited the production of estradiol, a hormone that is essential for ovulation. The study concluded that fluoxetine may have adverse effects on female reproductive function. But it’s not cut and dried. Koren et al. (2015) investigated the impact of SSRIs on pregnancy outcomes in women undergoing in vitro fertilization (IVF). The study found that there was no significant difference in pregnancy rates or miscarriage rates between women who were taking SSRIs and those who were not. But (isn’t there always…). A 2010 by Andersen et al. examined a potential link between antidepressant use and miscarriage using a pharmacy database. The authors found an increased risk of miscarriage in those women taking antidepressants during the first trimester compared to women who did not. However, they found a similarly increased risk of miscarriage in those women who stopped the antidepressant prior to conceiving.
In a nutshell - we need more research. Your mental health is so important - talk to your provider about what options might be best for you.
Your husband is taking antidepressants while trying to conceive?
Do Antidepressants Affect Male Fertility?
Effects of Antidepressants on Male Infertility: Men, SSRIs might be messing with your swimmers. Ramasamy et al. (2015) investigated the impact of SSRIs on sperm quality and found that men who had been taking SSRIs for more than six months had significantly lower sperm concentration, motility, and morphology compared to men who did not take antidepressants. The study concluded that long-term use of SSRIs may have a negative impact on male reproductive function.
Sertraline and Fertility - Does Zoloft Affect Fertility?
Another study by Tanrikut et al. (2010) investigated the impact of SSRIs on male fertility by evaluating the effects of sertraline (Zoloft) on semen quality. The study found that sertraline caused a significant reduction in sperm concentration and motility. The study also found that the longer the duration of sertraline use, the greater the reduction in sperm quality. But just like the research on women and fertility not all studies are in agreement. SSRIs can also produce some side effects, including nausea, headaches, weight gain, erectile dysfunction and diminished libido. A 2022 Systematic Review reported that the percentage of normal sperm morphology was significantly reduced with an SSRIs treatment duration of 3 months (p < 0.0001)) compared with 1 month of treatment.
The authors concluded: meta-analysis demonstrated that SSRIs have a statistically significant impairment on semen quality, such as sperm concentration, sperm morphology, sperm motility, and the DFI, but not on semen volume. Furthermore, the damage to sperm morphology and concentration were all observed in the 3-month period of SSRIs use but had no significant effect after 1 month of SSRIs use.
But There Is Good News
I talk to lots of women who are so overwhelmed with the medicalised treatment process of infertility especially IVF that signing up to take more medications is difficult to take. There is good evidence that lifestyle changes such as exercise, psychotherapy and adequate nutrition and sleep can improve mild to moderate depression. It’s estimated that approximately 30% of women will continue to experience depression and/or anxiety even after becoming pregnant and most women I work with prefer non-pharmaceutical options in pregnancy.
If taking anti-depressants just isn’t an option for you then a mindfulness-based approach may be just the ticket especially with more research questioning the efficacy of antidepressants and more emerging studies demonstrating significant initial and ongoing improvements in mental health with a mindfulness practice.
MBSR vs Escitalopram - Does Lexapro Affect Fertility?
Hoge et al., (2023) found that a mindfulness based approach (MBSR) was non-inferior to escitalopram (Lexapro). A 2017 study by Pasha et al., comparing depression and anxiety scores between women taking an 8-week mindfulness for fertility class and a second group of women taking antidepressants found significant improvement in depression symptoms in the mindfulness group.
If you’ve been on this journey for a while and aren’t feeling quite like yourself - do yourself and everyone around you a favor and find ways to nurture your heart and mind whether that’s with medication or a regular chat with a therapist.
You deserve to feel good!
Tracy
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4965341/
Consistent with this study Hoge et al., (2023) found that MBSR was noninferior to escitalopram (Lexapro).
