Influence of the selective serotonin re-uptake inhibitors on spermatogenesis

Introduction. Iinfertility leads to emotional stress, which is a precipitating factor of depression. Stress has also been recognized as one of possible reasons of pathospermia and infertility. The aim of study: to evaluate selective serotonin re-uptake inhibitors (SSRIs) effects on spermatogenesis in the treatment of depression. Material & Methods. Study included 19 fertile men with depression of mild severity. None of them had any urological disorders. They were treated by fluoxetine 20 mg per day during 6 weeks. Semen analysis (WHO 5), level of DNA fragmentation were performed before, after the therapy and 3 months of drug discontinuation. Results. All the men had normal semen parameters before the treatment. After 6 weeks of the treatment, we fixed the reduction of sperm's parameters & increasing the level of DNA fragmentation. After 3 mounts of drug discontinuation the mean semen volume, sperm concentration, motility, percentage of normal morphology increased & reverted to the normal levels. Sperm DNA fragmentation index decreased & it had the values less then before the treatment that correlated with the reduction of depression's symptoms. Conclusions. Using SSRIs may have a negative effect on spermatogenesis and male fertility within the therapy. The most changes of sperm quality (morphology & DNA integrity) were registered. 3 months of drug discontinuation the semen parameters reverted to the normal levels. Negative and positive effects of usage of SSRIs in infertile men with depression are to be studied in more detail.