SSRIs and Fertility

I got told there was a possible effect where SSRIs can (temporarily or permanently) damage fertility.

I've read a lot on the net, much of it providing conflicting information.

Does anyone have any clues from a RELIABLE source?

thanks

Can you be more specific, the nature of this infertility? A Pubmed search on fertility SSRI turned up no hits. Not one. fertility antidepressant turned up nothing relevant. Using reproductive and reproduction in similar searches didn't find what I think you're wondering about, either.

Apart from changes in sexual performance or desire, which are clearly associated with these drugs, and which some now wonder can be long-term (i.e. not necessarily reverting upon the end of treatment).....that's not what you were asking, is it?

Some atypical antipsychotics influence sex hormone levels, and that influences fertility. But that's a different class of drugs altogether.

Lar

Well I have only Googled ...

Stuff like this:
Is a history of depressive symptoms associated with an increased risk of infertility in women?

KL Lapane, S Zierler, TM Lasater, M Stein, MM Barbour and AL Hume
Division of Health Education, Memorial Hospital, Pawtucket, Rhode Island 02860, USA.

Researchers have reported an association between self-reported antidepressant use and increased risk of ovulatory infertility but could not control for confounding by the drug indication. We evaluated the role of depressive symptoms in the development of infertility. We recontacted a population-based sample of Pawtucket Heart Health Program (PHHP) health survey respondents to perform this case-control study. Self-reported infertility was defined as an inability to conceive after 12 months of unprotected intercourse. Controls were women who reported at least one pregnancy. The index age for infertile women was the age at which they first experienced fertility problems, and for the fertile women it was the age of their first pregnancy. History of depressive symptoms was based on self-report before the index age. Women with a history of depressive symptoms were nearly twice as likely to report infertility relative to women without a history of depressive symptoms before the index age after controlling for potential confounders (90% confidence interval: 0.9-3.2). Our data suggest that depressive symptoms as well as the drugs used to treat these conditions may play an important role in the pathogenesis of infertility. The association between depressive symptoms and infertility should be explored further.

This is suggesting that depressive symptoms themselves have more of an effect, but I have also read stuff (like the study referred to) that suggests antidepressant use can be a factor.

Right, there is no way so far to disentangle the depression effect from the effect of medication for the depression. Any person on antidepressants is still a person who needs them, so to speak. The underlying health factors are not treated by the antidepressant. At least, we can't assume they are.

Any study that I've ever seen that compared untreated depressed women and treated depressed women had the same outcomes: Similarly impaired fertility. Depressed women have lower fertility, treated or untreated.

The study you quote had a RR (relative risk) that included 1.0 (no effect at all) in its confidence interval, at the 90% level. To meet normal standards of 95%, the range is actually broader still. So, they didn't even use the standard signficance test, and they couldn't make the data show there was impairment.

The study is suggestive, at best. And, depression itself could be causing all the problems, all by itself.

Lar

Why do depressed women have lower fertility?

Hmmm ...

That would suck.

and thanks, larry

You're welcome. And, I'm sorry.

Lar

I hope I'm not over-posting on you, but I thought of a good comparison to consider.

Diabetics have a tendency to develop peripheral neuropathies of all sorts. If we looked at a class of diabetics, those who sought and obtained insulin as a treatment, we could probably show that those insulin-dependent diabetics had substantial, perhaps even higher rates of peripheral neuropathies than does the broader class of all diabetics.

Would we be making a mistake, if we blamed the insulin? I answer, without any doubt in my mind. Yes, we would absolutely be in error to blame the insulin.

Lar

yea i get the comparison ...

but sorry why?

it is good to hear these things from someone who actually knows what they are talking about.

i honestly thought (before i heard this stuff) that the only impact on fertility was due to less sexual pleasure so less desire to have intercourse so generally less opportunity to get knocked up (not that i am actually planning this at this point in time!!)

it's all confusing to me ...

Why?

You got me. So much for the "know what I'm talking about" bit, eh?

When you see a doctor, any specialist doctor, you see a guy who has focussed his attention of some compartment of the human body. It's like the seven wise men and the elephant. Each describes a very different beast than the other. An ob/gyn doc is not paying any attention to your brain, and we know very well that shrinks don't care about sexuality. Loss of sexuality is merely a side effect.

We are coming to realize that the brain is also a gland, in the sense of how it interacts with other glands. It is influenced by sex hormones, in a regulatory way. And it sends signals that influence the effect of sex hormones in other regions of the body.

There are so many, and so very complex, influences and interactions, I almost would say, "What doesn't affect sexuality? What doesn't influence fertility?"

Lar

I only have a theory, but I think, in general, positive emotions (those that express good things, in general) result in more positive health, and negative emotions (those that express bad things, in general) result in more negative health. That doesn't mean that happiness cures everything, but I think it raises one's chances. Now, sometimes we need negative emotions, like grief, but we have to express it to release it, and that helps us be healthy. That can make a "negative" emotion a positive one, in some ways. Still, too much of this pain will hurt us, even if it's not under our control.

It's just a theory. I have no medical degree.

I like that maven ... and i think physical and mental health are
very tied up too

larry i do undies stand now :P

i just find the idea of having lower fertility cos ur depressed quite horrid, no matter what the reason (sex drive, ADs, whatever).

:x