While we often focus on female fertility (and infertility) here at Natural Womanhood, male factor infertility is just as crucial when a couple is trying to conceive—it substantially affects around moitié of all cases of infertility, with global sperm counts cut in half since the 1970s [1] [2]. There are numerous raisons pourquoi infertilité masculine is on the rise, such as increased obesity, chronic disease, and environmental factors [3]. There may be another factor that has led to more men struggling with fertility, however: the increased use of selective serotonin reuptake inhibitors (SSRIs) and other psychotropic drugs used to treat depression and anxiety.
Use of antidepressants and other psychotropics is on the rise
SSRIs are the most common antidepressants taken today, typically prescribed for severe depression or anxiety. They work by blocking the uptake of serotonin (a neurotransmitter commonly called the “feel-good” chemical) which causes the body to make more serotonin, often decreasing symptoms of depression. There are numerous SSRIs on the market which all have common side effects like weight gain, headaches, and decreases in libido. It’s been an open question whether or not SSRIs affect fertility, but in recent years there have been more and more studies published on the matter.
In this article, we’ll dive into a systematic review of a large number of studies asking whether or not taking SSRIs affect male fertility (and for more on how they impact female fertility, see here). We’ll discuss why SSRIs may play a role in male infertility, and whether this effect is reversible.
SSRIs and male fertility: reviewing the available data
“Selective Serotonin Reuptake Inhibitors (SSRIs): Effects on male fertility” is a systematic review published in 2025 by a group of Brazilian researchers who conducted a wide survey of 125 recent studies on SSRIs and male infertility [4]. The researchers selected 18 of the most salient articles for further analysis, with ten of the studies making the final cut into the systematic review. The final studies chosen looked at multiple types of antidepressants/psychiatric medications (not only SSRIs) and their effects on multiple factors of male infertility, including serum testosterone levels and sperm production. These studies were a mixture of animal and human research.
What the data showed
Overall, the systematic review found that taking SSRIs does, in fact, contribute to male infertility, as it decreases the concentration and motility of sperm, increases the abnormal morphology and DNA fragmentation of sperm, and significantly decreases testosterone levels in the men taking the antidepressant. That being said, not all of the studies they analyzed showed the same amount of effect for all kinds of SSRIs.
For example, one of the human études from 2021 tested a variety of psychiatric medications, including SSRIs, benzodiazepines, and antipsychotics. This study showed that certain types of mental health medications (Xanax, Zyprexa, and Keppra) did pas seem to have an effect on semen concentrations, while users of Prozac (a common SSRI), Seroquel, and Abilify all had significantly lower sperm concentration and motility [5]. It is worth noting, however, that tous of the medications had a negative effect on sperm motility.
The animal studies generally showed more significant effects, with a Étude de 2016 showing that all of the animals treated with Luvox had negative impacts on their sperm production and also showed signs of increased oxidative stress [6].
Why might SSRIs affect male fertility?
While the specific mechanisms by which SSRIs affect male fertility are still unclear, researchers do have some ideas about why SSRIs have this impact. Antidepressants can increase serum prolactin levels, which is a hormone that (when elevated) can decrease sexual function and semen quality. It can also lead to reversible suppression of spermatogenesis, meaning that the creation of sperm is put on hold while prolactin levels are up. More research needs to be done to understand fully why SSRIs have a negative effect on testosterone and sperm quality, however.
Antidepressants can increase serum prolactin levels, which is a hormone that (when elevated) can decrease sexual function and semen quality. It can also lead to reversible suppression of spermatogenesis, meaning that the creation of sperm is put on hold while prolactin levels are up.
Limitations of the review
Though the 2025 systematic review looked at a large number of studies on the topic of SSRIs and male infertility, one limitation is the fact that many of the studies analyzed are animal studies rather than human. While animal studies are important in research, a lack of high-quality human studies on a topic typically means that there needs to be more research to fully understand this issue.
That being said, there are other systematic reviews on the subject, such as ce document from 2022 which cast a much larger net of article reviews, but ultimately looked at four studies with all human participants [7]. In that 2022 meta-analysis, researchers also found that SSRIs have a significant impact on sperm concentration, morphology, and motility, with observable damage to sperm within just three months of using SSRIs. In total, these four studies only included 222 male participants, a limited number that again shows the necessity for more human trials (with greater numbers of participants) on how SSRIs may affect male fertility.
It’s also important to note that there are a wide variety of SSRI medications on the market that are all slightly different from each other, and not all of them have been studied to the same degree. Prozac (fluoxetine) is by far the most studied antidepressant drug regarding its effects on male fertility. This imbalance of research means that more studies need to be done on all forms of SSRIs (and other psychiatric medications such as benzodiazepines and antipsychotics), to give us a better idea of whether some drugs have a larger effect on fertility than others.
Are the effects of SSRIs on male fertility reversible?
Another key factor in these trials is that all of them studied the fertility of men (or male rats) who were currently being treated with SSRIs. This is an important distinction to make, because if antidepressants only affect a man’s fertility while he is currently using them, then an obvious option would be for a man struggling with infertility to attempt to responsibly wean off his SSRIs over a period of time while trying to conceive.
Fortunately, in the 2025 systematic review, many of the studies analyzed did in fact point to at least some level of reversibility. One of the animal études from 2016 showed that after ceasing treatment with Luvox (fluvoxamine) for eight weeks, the adverse effects on fertility were no longer observable [8]. A 2020 examen also stated that the majority of the negative effects caused by the SSRI seem to be reversible once the medication is discontinued, and a Portuguese étude from 2022 has some early data suggesting that the oxidative stress caused by SSRIs which harm fertility may possibly be mitigated by nutrient supplementation [9].
Overall, the data does seem to show that the effects of SSRIs on male fertility may be reversible. However, the research on this subject is still quite limited, and needs more data from human-based trials which specifically test for the reversibility factor. Notably, the Société américaine de médecine de la reproduction a listed antidepressants as a réversible cause of abnormal sperm DNA fragmentation, showing that much of the current research points to the negative fertility effects of antidepressants as being reversible once men discontinue their use.
Overall, the data does seem to show that the effects of SSRIs on male fertility may be reversible. However, the research on this subject is still quite limited, and needs more data from human-based trials which specifically test for the reversibility factor.
The bottom line on SSRIs and male fertility
For those who struggle with anxiety or depression and find that antidepressants have been helpful in managing their mental health, it can be frustrating to hear that SSRIs may be playing a part in their difficulty to conceive. The good news is that many studies do point to a reversibility of effects on fertility, so hopefully struggles with fertility may resolve with discontinuation of use.
That being said, discontinuing SSRIs is a serious decision that should only be done with the support of a doctor, and while carefully weighing the risks and benefits of discontinuation. Withdrawal symptoms are very common when coming off an SSRI, so it’s important to have a plan with your physician for the proper timing of discontinuation and symptom management. If you are still struggling with depression, it’s important to have a plan for how you are going to continue managing your mental health once you’ve gotten off antidepressants.
Finally, it’s necessary to point out that SSRIs are far from the only factor harming male fertility, and there may be other changements that you can make in your diet and lifestyle to improve your fertility before you consider coming off antidepressants. A great place to start if you are a man (or woman) looking to improve your fertility is Lily Nichols and Lisa Hendrickson-Jack’s book De vrais aliments pour la fertilité, which has a specific chapter on male-factor infertility.
While SSRI use likely negatively impacts fertility, there are a host of options to consider for those looking to naturally boost their fertility, with or without discontinuing antidepressants.
Références
[1] Leslie SW, Soon-Sutton TL, Khan MAB. Male Infertility. [Updated 2024 Feb 25]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK562258/
[2] Levine H, Jørgensen N, Martino-Andrade A, Mendiola J, Weksler-Derri D, Mindlis I, Pinotti R, Swan SH. Temporal trends in sperm count: a systematic review and meta-regression analysis. Hum Reprod Update. 2017 Nov 1;23(6):646-659. doi: 10.1093/humupd/dmx022. PMID: 28981654; PMCID: PMC6455044.
[3] Okonofua FE, Ntoimo LFC, Omonkhua A, Ayodeji O, Olafusi C, Unuabonah E, Ohenhen V. Causes and Risk Factors for Male Infertility: A Scoping Review of Published Studies. Int J Gen Med. 2022 Jul 4;15:5985-5997. doi: 10.2147/IJGM.S363959. PMID: 35811778; PMCID: PMC9268217.
[4] Oliveira RA, Santos SCD, Lima VLM, Adami LNG. Selective Serotonin Reuptake Inhibitors (SSRIs): Effects on male fertility. JBRA Assist Reprod. 2025 Jul 30;29(2):351-358. doi: 10.5935/1518-0557.20240109. PMID: 40371979; PMCID: PMC12225138.
[5] Mazzilli R, Curto M, De Bernardini D, Olana S, Capi M, Salerno G, Cipolla F, Zamponi V, Santi D, Mazzilli F, Simmaco M, Lionetto L. Psychotropic Drugs Levels in Seminal Fluid: A New Therapeutic Drug Monitoring Analysis? Front Endocrinol (Lausanne). 2021 Mar 11;12:620936. doi: 10.3389/fendo.2021.620936. PMID: 33776918; PMCID: PMC7992038.
[6] Galal AA, Alam RT, Abd El-Aziz RM. Adverse effects of long-term administration of fluvoxamine on haematology, blood biochemistry and fertility in male albino rats: a possible effect of cessation. Andrologia. 2016 Nov;48(9):914-922. doi: 10.1111/and.12532. Epub 2016 Jan 15. PMID: 26771175.
[7] Xu J, He K, Zhou Y, Zhao L, Lin Y, Huang Z, Xie N, Yue J, Tang Y. The effect of SSRIs on Semen quality: A systematic review and meta-analysis. Front Pharmacol. 2022 Sep 14;13:911489. doi: 10.3389/fphar.2022.911489. PMID: 36188547; PMCID: PMC9519136.
[8] Galal, A.A.A., Alam, R.T.M. and Abd El-Aziz, R.M. (2016), Adverse effects of long-term administration of fluvoxamine on haematology, blood biochemistry and fertility in male albino rats: a possible effect of cessation. Andrologia, 48: 1002-1010. https://doi.org/10.1111/and.12532
[9] Beeder, L.A. and Samplaski, M.K. (2020), Effect of antidepressant medications on semen parameters and male fertility. Int. J. Urol., 27: 39-46. https://doi.org/10.1111/iju.14111
