Are Antidepressants Linked to Male Infertility?

My husband and I have been trying to conceive for almost a year now. He recently started seeing an ED therapist, who said it is likely the multitude of antidepressants he was put on as a kid while doctors were trying to figure out what to do with him, prolonged use of cannabis as a way to find some relief, and his current medication after finally receiving a bipolar diagnosis in his 30s are contributing to his inability to perform and our inability to conceive. Dewey helpfully shared information about a woman’s use of SSRIs in pregnancy, but what about the likelihood of being able to conceive when it’s male use of antidepressants that’s the question? Are we doomed unless he goes off the medication that helps him stay afloat?

—Manic on Multiple Fronts Now

First, let me say I’m sorry you are dealing with this. Struggling to conceive is difficult enough without vague diagnoses that leave you with impossible choices.

The evidence on antidepressants and male infertility is not enormously conclusive. There is some work suggesting that SSRIs in particular may impact sperm concentration and motility, but this is mostly in vitro work, and it isn’t always clear whether that would translate to decreases in realized conception. A lot of these studies are in rats, which are good models for humans but not always that precise. Work on non-SSRI medications is even less broad. SSRIs can also contribute to lower sex drive and erectile dysfunction in men, which can impact fertility.

Cannabis is also known to lower sperm counts, although, as with most things that impact sperm, this effect is reversible (since sperm is consistently produced over time). My read is that your husband is no longer using cannabis to manage his diagnosis.

Overall: It is possible that the medications he is on are impacting sperm. It is also possible they are not, or that despite any impacts, his sperm parameters are fine.

Which leads me to my main piece of advice here: Stop worrying about why, and focus on steps to solutions.

You are looking for an answer without having identified the problem. If you have been trying to conceive for a year, it is worthwhile to reach out to an OB or fertility specialist to discuss your options. This is true regardless of the reason why. One of the things they will likely do is test your husband’s sperm, in addition to everything else. This will give you some answers, and you can go from there.