Do Antidepressants Cause Infertility?

According to research, there is a correlation between the use of antidepressants and infertility. Some studies suggest that there is no conclusive evidence that female fertility is affected by the use of antidepressants, while most others show strong evidence that male fertility is affected by antidepressants.

There is also much debate and discussion on the topic – do antidepressants affect female and male fertility? Firstly, antidepressants have side effects on one’s sex drive. That indirectly affects fertility. Sometimes, it can also be the other way around, because trying to conceive itself can cause depression. That may make you take antidepressants, which can affect your libido and ability to reproduce. Depression and its related problems can also impact your ability to conceive.

There is also the allied issue of pregnancy and antidepressants, once you have already conceived. A theory suggests that stopping antidepressants can cause a depressing pregnancy that can affect foetal health and result in preterm labour, miscarriages, etc.

What Are Antidepressants?

Antidepressants are medications designed to alleviate symptoms of depression and other mental health conditions, such as anxiety disorders, by balancing chemicals in the brain, particularly neurotransmitters like serotonin, norepinephrine, and dopamine (1). They work by increasing the availability of these neurotransmitters or improving their function, which can help regulate mood, reduce feelings of sadness or hopelessness, and improve overall emotional well-being. While effective for many, they may take weeks to show results and can have side effects, so they are typically used in combination with therapy and lifestyle changes for optimal mental health management.

Different Types of Antidepressants

Antidepressants help treat depression and anxiety by balancing brain chemicals like serotonin and norepinephrine. They fall into different categories, each with unique effects and side effects (2).

• SSRIs: Boost serotonin levels; commonly prescribed due to mild side effects.
• SNRIs: Target serotonin and norepinephrine; also used for chronic pain.
• TCAs: Older antidepressants with more side effects, but sometimes used for resistant cases.
• Atypical antidepressants: Work differently—some increase energy, while others help with sleep.

Can Antidepressants Cause Infertility?

Anti-depressants can cause infertility in men, but not so much in women. However, one has to be cautious about concluding that antidepressants are the real cause of infertility. (3).

Depression itself affects one’s sex drive and fertility. Moreover, depressed people often indulge in substance abuse, over-eating, poor diet, and lack of exercise, which lead to overall health issues that affect fertility. Higher levels of cortisol, the stress hormone, can also impact fertility.

Please consult your doctor for the exact cause of your infertility, because it may be due to multiple factors, and not merely due to antidepressants.

Effects of Antidepressants on Male Fertility

Antidepressants cause higher DNA fragmentation in sperms. This fragmentation may adversely impact the capability of sperms to fertilise eggs. This does not occur in the sperm of men who have never taken antidepressants. So, antidepressants may cause infertility in men. One of the most common antidepressants is Selective Serotonin Reuptake Inhibitors (SSRIs) (4). These have also been associated with erectile dysfunction and ejaculation problems, because they impact the hormones in the body. These are temporary problems, because they go away once stop the medication. However, SSRIs have a minimal impact on female fertility.

Effects of Antidepressants on Female Fertility

There is not much data available on how antidepressants affect female fertility. A lot more research needs to be done on whether it’s the depression or the antidepressants that affect female fertility.

Studies have suggested that at best it may affect the female libido with an indirect impact on fertility. Some studies concluded that SSRIs are comparatively safer for female use while conceiving and during pregnancy. According to another study, women on antidepressants find it difficult to conceive naturally.

If you are on antidepressants and trying to conceive, be aware that the researchers have concluded that being on antidepressant medication definitely decreases the chances of a woman getting pregnant that month.

If you are planning on getting pregnant while on antidepressants, consult your doctor to know how it impacts you.

What Should You Do if You’re Taking Antidepressants and Want to Have a Baby?

So, now that you have decided to have a baby while on antidepressants, what is the best way forward? How can you make antidepressants and conception go hand-in-hand for a healthy and safe conception? This is also relevant for the husband on antidepressants. Here are some tips for everybody:

• Visit your doctor and discuss whether the antidepressants are improving or worsening your condition, or having no impact on you. Discuss how the dosage can be adjusted accordingly.
• You can try out alternative therapy like cognitive behavioural therapy (CBT), yoga, counselling therapy, family support, diet and lifestyle changes etc. These can help you reduce dependence on antidepressants.
• If you or your husband’s family has a history of depression, discuss it with a specialist. Find out what would be best for you, your family, and the baby to come.
• You can take some other medication like Viagra along with antidepressants to boost your libido.

Studies have suggested that sildenafil (Viagra), ‘improved sexual function in 55% of men’ when taken with antidepressants. However, do not self-medicate. Ask your doctor if it is safe for you.

• Try to stay off the antidepressants sometimes. Try to conceive at that time. Check with your doctor if that is safe to do with the kind of antidepressant you are taking.
• If you have acute or complex depression, use of antidepressants are necessary and can even be a life-saver. So, please see your doctor before you take any steps.

FAQs

1. Do antidepressants disrupt ovulation or menstrual cycles?

Hormonal fluctuations caused by antidepressants (e.g., SNRIs, TCAs) may occasionally lead to irregular periods or delayed ovulation, though this isn’t common for most users.

2. Could long-term antidepressant use lower fertility chances?

Research is mixed, but long-term SSRI use has been linked in some cases to reduced fertility in both men and women—possibly due to hormonal changes or sexual dysfunction side effects.

3. Can stopping antidepressants suddenly improve fertility?

Abruptly discontinuing antidepressants is not recommended, as withdrawal symptoms may occur. While some individuals report improved fertility after tapering off medication, there’s limited evidence to confirm a direct link. Hormonal balance and mental health should be carefully managed.

4. Do antidepressants impact IVF or fertility treatment success rates?

Some studies suggest SSRIs might slightly alter uterine receptivity or embryo implantation, but findings are inconclusive. If undergoing IVF, consult a fertility specialist to weigh the risks of continuing or adjusting medication.

This was all about antidepressants and fertility. Antidepressants and fertility are both very complex and can have life-changing consequences. Therefore, make sure you talk to your doctor before making decisions.

References/Resources:

1. National Library of Medicine – Antidepressants

2. NHS – Overview – Antidepressants

3. National Library of Medicine – The Effect of Antidepressants on Fertility

4. National Library of Medicine – Effects of selective serotonin reuptake inhibitors on sperm and male fertility

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