Infertility risk rises for men on depression meds

CORNELL (US)—As many as half the men who take antidepressant medication have a reduced ability to conceive and more than a third report significant changes in erectile function, a new study finds.

The research also shows that changes are reversible with normal levels of both sexual function and DNA damage to sperm returning one month after discontinuation of the drug.

“It’s fairly well known that SSRI antidepressants negatively impact erectile function and ejaculation,” says Peter Schlegel, chair of the Department of Urology and professor of reproductive medicine at Weill Cornell Medical College and urologist-in-chief at NewYork-Presbyterian Hospital/Weill Cornell Medical College.

“This study goes one step further, demonstrating that they can cause a major increase in genetic damage to sperm,” explains Schlegel, the study’s senior author.

Published in the online edition of the journal Fertility & Sterility, the study followed 35 healthy male volunteers who were given paroxetine for five weeks. The drug was used because of its relatively short half-life and because it has previously shown to exert the strongest effect in delaying ejaculation.

Results showed the percent of participants with abnormal DNA fragmentation rose from less than 10 percent to 50 percent while taking the drug. DNA fragmentation, the authors note, is known to correlate with poorer fertility and pregnancy outcomes, even when techniques such as in vitro fertilization and intracytoplasmic sperm injection are applied. It also has been linked with an increased risk for birth defects.

Evidence shows the drug causes sperm to get “hung up” as it travels through the male reproductive tract, explains Cigdem Tanrikut, currently adjunct assistant professor of urology and reproductive medicine at Weill and the study’s lead author.

“Our main clue is that DNA integrity was quickly restored once the study participants stopped taking the drug, says Tanrikut. “This would have taken much longer had sperm production been affected.”

“This is a new concept for how drugs can affect fertility and sperm,” notes Schlegel. “In most cases, it was previously assumed that a drug damaged sperm production, so the concept that sperm transport could be affected is novel.”

Schlegel notes that about half of all infertility issues are related to men’s health. “It is our hope that this research can improve couples’ chances for conception, and potentially better our ability to create drugs that won’t get in the way.”

Researchers at Massachusetts General Hospital and Harvard Medical School contributed to the study, which was supported with help from the Frederick and Theresa Dow Wallace Fund of the New York Community Trust.

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