Recent years have seen a steady increase in couples seeking consultation for infertility, affecting approximately 10% to 15% of the sexually active population. Male factor infertility (MFI) is thought to be responsible for up to 50% of these cases in developed countries. While various factors contribute to MFI, including hormonal and anatomical issues, the role of pharmaceutical medications is gaining attention. This review examines the influence of specific medications on MFI, highlighting that in many cases, the induced infertility is treatable and reversible.

What is WS-TCM?

According to the World Health Organization infertility affects between 48 million couples and 186 million individuals globally. Male factor infertility (MFI) is thought to be responsible for up to 50% of these cases in developed countries (Boitrelle et al., 2021). Approximately 50% of all infertility cases are related to male factor (MFI). MFI, primarily diagnosed through abnormalities in semen analysis, is a significant contributor to overall infertility issues. Key parameters like sperm count, motility, and morphology are critical in assessing semen quality. Male infertility can be multifactorial, and can be attributed to hormonal and anatomical issues as well as pharmaceutical medications.

Medication-Induced Male Infertility: An Emerging Concern

Antidepressants

Depression, affecting roughly 16% of the population over a lifetime, has led to a surge in antidepressant usage, particularly selective serotonin reuptake inhibitors (SSRIs). While SSRIs are the preferred treatment for depression, their impact on male fertility is a growing area of concern. Research suggests that SSRIs may affect sperm quality, although the evidence is not yet conclusive.

Case Studies and Trials

A 2006 study by Weill Cornell Medical College proposed a link between SSRIs and MFI, with subsequent research in 2010 showing significant sperm DNA fragmentation in men using paroxetine, an SSRI.

Another study found an association between SSRI usage and decreased sperm motility.

In vitro studies indicate that SSRIs might have a spermicidal effect.

The Broader Context

MFI can result from pre-testicular, testicular, or post-testicular issues, with a significant number of cases having no identifiable cause. Pharmaceutical and recreational drugs are known to impact semen production and erectile function, thereby contributing to MFI.

Conclusion

The relationship between various medications and MFI is complex and multifaceted. While certain drugs like SSRIs have been implicated in causing MFI, the evidence is still evolving. The necessity for larger and more comprehensive studies is evident to conclusively establish these links. For now, the data suggest a potential impact, warranting careful consideration when prescribing these medications to men of reproductive age.