Pittsburgh—With as many as 11% of women undergoing in vitro fertilization (IVF) also taking depression drugs, a new study is especially significant.

The article in the Harvard Review of Psychiatry reports that, based on limited research, no strong evidence was found that selective serotonin-reuptake inhibitors (SSRIs) adversely affect fertility, although there is some indication that sperm count can be impacted.

University of Pittsburgh Medical Center authors conclude, “There is insufficient evidence at present to propose that SSRIs reduce fertility or influence infertility-treatment outcomes. SSRIs may have an adverse impact on sperm quality, but further research is warranted.”

The study notes that infertility, which affects about one in six American couples, has been linked to increased rates of psychological distress and depressive symptoms. In fact, it adds that 4% to 11% of women undergoing IVF are also on SSRIs at the time of treatment.

Researchers’ conclusions were based on a meta-analysis of 16 previous studies of the association between SSRIs and fertility and infertility-treatment outcomes.

The study team identified seven studies that evaluated the effect of antidepressants in couples receiving infertility treatment, with six of them indicating no significant association between SSRIs and infertility-treatment outcomes. At the same time, three studies showed possible trends toward a lower probability of pregnancy per IVF cycle or reduced fertility biomarkers in women taking SSRIs, while one found the opposite—that SSRIs were associated with increased pregnancy rates.

Researchers note that just two studies looked at the effects of SSRIs in fertile women, with one of them suggesting a lower probability of conception in women who had depressive symptoms, but not in those taking antidepressants.

Among the seven studies that looked at male fertility and SSRIs, six found that the SSRIs negatively affected semen parameters and sperm quality. The authors questions the results because of limitations in the studies, however.

“In reproductive-age men and in couples trying to conceive, a discussion regarding the possible effects of SSRIs on sperm and fertility may be warranted,” the researchers write, emphasizing the complex associations between depression, antidepressants, and infertility. The authors call for further studies in fertile men and women and in couples seeking treatment for infertility to help answer some of the questions.

“It is important to weigh the possible benefits of antidepressant medication against any potential risks, including the potential impact of untreated depression, on fertility in couples trying to conceive,” the researchers add. They suggest the possibility of psychotherapy as an effective alternative to antidepressants for patients with mild depression and anxiety, which might be related to an infertility diagnosis.

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