Urology. 2007 Jan;69(1):185.e5-7.
Antidepressant-associated changes in semen parameters.
Abstract
We describe 2 cases of patients referred for evaluation of male infertility who had antidepressant medication-associated changes in sperm motility and/or concentration. The physical examination and endocrinologic study findings were unremarkable in each case. Analysis of the initial semen specimens revealed oligospermia, impaired motility, and abnormal morphology in each patient while they were taking serotonin reuptake inhibitors. Repeat semen analyses performed 1 to 2 months after discontinuation of the antidepressants demonstrated marked improvements in sperm concentration and motility. Additional assessment of the potential impact of antidepressant medications on male fertility is warranted.
- PMID:
- 17270655
- DOI:
- 10.1016/j.urology.2006.10.034
- [Indexed for MEDLINE]
Fertil Steril. 2010 Aug;94(3):1021-6. doi: 10.1016/j.fertnstert.2009.04.039. Epub 2009 Jun 10.
Adverse effect of paroxetine on sperm.
Abstract
OBJECTIVE:
To assess the effects of a selective serotonin reuptake inhibitor on semen parameters.
DESIGN:
Prospective study.
SETTING:
Academic medical center.
PATIENT(S):
Thirty-five healthy male volunteers, 18-65 years old.
INTERVENTION(S):
Paroxetine administration for 5 weeks.
MAIN OUTCOME MEASURE(S):
Serum hormone levels, semen analyses, percent sperm DNA fragmentation, and questionnaire assessment of sexual function assessed before, during, and 1 month after drug administration.
RESULT(S):
Mean sperm DNA fragmentation was significantly higher for men while on paroxetine (30.3%) versus baseline (13.8%). Before paroxetine, 9.7% of patients had a terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) score>or=30% compared with 50% at week 4 of treatment. The odds ratio (OR) of having abnormal DNA fragmentation while taking paroxetine was 9.33 (95% confidence interval, 2.3-37.9]. Multivariate logistic regression correcting for age and body mass index confirmed this correlation (OR, 11.12). Up to 35% of men noted significant changes in erectile function and up to 47% of men reported ejaculatory difficulties on medication. Recovery to near-normal sexual function was noted after stopping treatment. Standard semen parameters were not significantly altered during paroxetine treatment.
CONCLUSION(S):
In men with normal semen parameters, paroxetine induced abnormal sperm DNA fragmentation in a significant proportion of subjects, without a measurable effect on semen parameters. The fertility potential of a substantial number of men on paroxetine may be adversely affected by these changes in sperm DNA integrity.
Copyright (c) 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.
Comment in
- Re: adverse effect of paroxetine on sperm. [J Urol. 2011]
- PMID:
- 19515367
- DOI:
- 10.1016/j.fertnstert.2009.04.039
- [Indexed for MEDLINE]
Int J Impot Res. 2012 Sep;24(5):171-3. doi: 10.1038/ijir.2012.12. Epub 2012 May 10.
Deleterious effects of selective serotonin reuptake inhibitor treatment on semen parameters in patients with lifelong premature ejaculation.
Abstract
Premature ejaculation (PE), the most common sexual dysfunctions in men, is characterized by loss or absence of ejaculatory control. PE can be classified as either a lifelong or acquired condition. Although the prevalence of lifelong PE is rather low in the general male population, recent studies demonstrated that the patients who seek treatment for their rapid ejaculation mostly report lifelong PE. Although no drug for PE has been approved by regulatory bodies, chronic selective serotonin reuptake inhibitors (SSRIs) proved to be effective in treating lifelong PE. Despite the rising use and known effects of antidepressants on ejaculation, only a few reports have evaluated the impact of these drugs on the male fertility. Thus, the aim of this review is to evaluate the efficacy and adverse effects of SSRIs on semen parameters of patients with lifelong PE as well as to assess the safety of this treatment among sexually active couples who desire to have a child.
- PMID:
- 22573230
- DOI:
- 10.1038/ijir.2012.12
- [Indexed for MEDLINE]
Prescrire Int. 2015 Jan;24(156):16-7.
Semen abnormalities with SSRI antidepressants.
[No authors listed]
Abstract
Despite decades of widespread use, the adverse effect profile of "selective" serotonin reuptake inhibitor (SSRI) antidepressants has still not been fully elucidated. Studies in male animals have shown delayed sexual development and reduced fertility. Three prospective cohort studies conducted in over one hundred patients exposed to an SSRI for periods ranging from 5 weeks to 24 months found altered semen param-eters after as little as 3 months of exposure: reduced sperm concentration, reduced sperm motility, a higher percentage of abnormal spermatozoa, and increased levels of sperm DNA fragmentation. One clinical trial showed growth retardation in children considered depressed who were exposed to SSRls. SSRls may have endocrine disrupting properties. Dapoxetine is a short-acting serotonin reuptake inhibitor that is chemically related to fluoxetine and marketed in the European Union for men complaining of premature ejaculation. But the corresponding European summary of product characteristics does not mention any effects on fertility. In practice, based on the data available as of mid-2014, the effects of SSRI exposure on male fertility are unclear. However, it is a risk that should be taken into account and pointed out to male patients who would like to father a child or who are experiencing fertility problems.
- PMID:
- 25729824
- Reprod Fertil Dev. 2018 Apr 30. doi: 10.1071/RD17384. [Epub ahead of print]
Fluoxetine treatment of prepubertal male rats uniformly diminishes sex hormone levels and, in a subpopulation of animals, negatively affects sperm quality.
Abstract
Fluoxetine (Flx) is a selective serotonin reuptake inhibitor that alters the male reproductive system when administered at the adult stage or after maternal exposure. In the present study we evaluated the effects of Flx administration on reproductive parameters during juvenile-peripubertal development when treated male rats reached adulthood. Groups of rats were treated daily with Flx (5mgkg-1, i.p.) or saline (0.9% NaCl), or were left untreated. Rats were treated between 30 and 53 days of age and were killed at 65 days of age. Serotonin concentrations were determined in the hypothalamus, hypophysis and testis. Gonadotrophins, sex steroids and sperm quality (membrane integrity, sperm with functional mitochondria, sperm density, sperm motility and morphological abnormalities) were also evaluated. Flx did not affect bodyweight, but significantly diminished LH, FSH, progesterone and testosterone serum concentrations. After graphical analysis, a subgroup of rats was identified whose sperm quality parameters were greatly affected by Flx. In the present study we show that Flx administered to juvenile rats disrupts the hypothalamic-hypophyseal-testicular axis and its effects on sperm quality are not homogeneous in adults. In contrast, Flx altered concentrations of gonadotrophins and sexual steroids in all treated rats. These results suggest caution should be exercised in the prescription of Flx to prepubertal males.- PMID:
- 29706148
- DOI:
- 10.1071/RD17384
