According to the National Institute of Mental Health, depressive disorders afflict over six
million U.S. men annually. Most cases of moderate or severe depression are treated with
antidepressants, including monoamine oxidase inhibitors, tricyclic antidepressants, and, more
recently, selective serotonin reuptake inhibitors (SSRIs) and antidepressants with modest
serotonin and norepinephrine reuptake inhibition but unknown mechanism-of-action. Over the
past two years, prescribing data show a steady increase in antidepressant dispensing rates
(especially including serotonin reuptake inhibitors) for adults. SSRIs are known to have an
effect on ejaculatory function and are therapeutically used for treatment of premature
(rapid) ejaculation. However, few studies have evaluated the potential impact of
antidepressant medications on male fertility, and no studies have been published with respect
to the impact of newer antidepressants, such as SSRIs, on male fertility. In the high-volume
male infertility practice at New York Hospital-Cornell Medical Center, several patients have
presented who have had a clear temporal association between SSRI use and impairment in sperm
motility and/or sperm transport (emission). These men have shown improvement in sperm counts
and motility after discontinuation of antidepressant medications.