Antidepressants and Fertility: The Effect of Antidepressants on Fertility

Reviewed By: Dr. Anusha Kushanapally, fertility specialist at Ferty9 Fertility Clinic, Warangal

Depression is a frequently heard mental health condition. It affects millions of people worldwide. While antidepressants are commonly prescribed to alleviate the symptoms of depression, their potential impact on fertility has been a subject of concern for many couples who are planning to conceive or are already pregnant. This article delves into the effects of antidepressants on fertility and explores the various types of antidepressants. Let's understand the side effects of antidepressants and strategies for managing depression while trying to conceive.

Also read: Trying to Conceive : Pro’s and Cons

What are Antidepressants?

Antidepressants are primarily used to treat and manage depression, anxiety disorders & other mental health conditions. These drugs alter the neurotransmitter levels (serotonin, norepinephrine & dopamine) in the brain. These chemicals are known for their power to regulate mood and emotional well-being.

Also read: The Impact of Stress on Fertility

Types of Antidepressants

There are several types of antidepressants, each with its own mode of action & potential side effects. The following are some of the most common antidepressant medicines are:

• Selective Serotonin Reuptake Inhibitors (SSRIs): SSRIs are the most effective antidepressant medicines.
• Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)
• Monoamine Oxidase Inhibitors (MAOIs)
• Atypical Antidepressants

Related Read: The Impact of Stress on Men’s and Women’s Sexual Health

Side Effects of Antidepressants on Fertility

While antidepressants can be effective against depression, they may also have potential side effects that can impact fertility in both males and females.

Hormonal Imbalances

Certain antidepressants, particularly SSRIs and SNRIs, can disrupt hormonal balance in the body, including those involved in reproductive function. This hormonal imbalance can interfere with ovulation, sperm production, and overall fertility.

Menstrual Cycle Disruption

Antidepressants have been associated with irregular menstrual cycles, missed periods, or abnormal bleeding patterns in some women. These disruptions make it difficult to predict ovulation and increase the difficulty of conceiving.

Reduced Sperm Quality

Some studies have suggested that antidepressants, particularly SSRIs, may have some side effects of antidepressants in males, including sperm count, motility, and morphology. This reduction in sperm quality can decrease the chances of successful fertilisation.

Sexual Dysfunction

Sexual dysfunction (decreased libido, erectile dysfunction, and difficulty achieving orgasm) is a common depression pill's side effects. These issues can make it challenging for couples to engage in sexual activity and conceive naturally.

Potential for Weight Changes

Certain antidepressants, such as mirtazapine and paroxetine, have been linked with abnormal weight gain or weight loss. Significant changes in body weight can affect fertility by disrupting hormonal balance and ovulation.

Impact on Ovulation

Some antidepressants, particularly SSRIs and SNRIs, have been linked to ovulatory dysfunction, which can make it more difficult for women to conceive naturally or through assisted reproductive methods like in vitro fertilisation (IVF). According to a study, women who are taking antidepressant pills for more than six months may encounter long-term side effects of antidepressants, like an increased risk of infertility.

Side Effects of Antidepressants in Females During Pregnancy

If a woman becomes pregnant while taking antidepressants, there are potential risks to the baby in the womb that should be carefully considered.

Increased Risk of Birth Defects

Some studies have advocated a slightly increased risk of certain congenital or birth defects, such as heart defects, when antidepressants are taken during pregnancy, particularly during the first trimester when organ development occurs.

Preterm Birth

The use of certain antidepressants, particularly SSRIs, has been associated with a heightened risk of preterm birth (birth before 37 weeks of gestation).

Low Birth Weight

Babies born to mothers who had antidepressants during pregnancy may have a slightly increased likelihood of low birth weight. Low birth weight can make a baby prone to various health complications.

Neonatal Withdrawal Symptoms

Infants exposed to antidepressants in utero may experience withdrawal symptoms after birth, such as irritability, excessive crying, tremors, and difficulty feeding or sleeping.

Respiratory Issues

Some research has suggested that exposure to certain antidepressants during pregnancy may increase the risk of persistent pulmonary hypertension in newborns, a condition that can cause respiratory distress.

Possible Effects on Infant Development

While the evidence is limited, some studies have raised concerns about the potential long-term effects of prenatal antidepressant exposure on infant development, including cognitive, behavioural, and emotional development.

Suggested read: How Do Autoimmune Diseases Impact Fertility and Pregnancy?

Managing Depression While Trying to Conceive

For individuals who are planning to conceive or are currently trying to become pregnant, it is essential to discuss their treatment options with a doctor. Here are some strategies that may be considered:

• Explore Non-pharmacological Treatments: Before starting or continuing antidepressant medication, consider exploring non-pharmacological treatments such as psychotherapy, counselling, exercise, mindfulness practices, or lifestyle modifications.
• Evaluate the Risks and Benefits: If antidepressant treatment is deemed necessary, discuss the potential risks and benefits with a doctor, considering factors such as the severity of depression, the type of antidepressant, and the individual's fertility goals.
• Consider Switching Medications: If a particular antidepressant is known to have a higher risk of fertility-related side effects, a doctor may recommend switching to an alternative medication with a potentially lower risk profile.
• Adjust Dosage or Timing: In some cases, adjusting the dosage or timing of antidepressant medication may help minimise potential fertility-related side effects.
• Monitor Closely: If antidepressant treatment is continued during pregnancy, doctors should monitor closely the health of the mother and the developing foetus with regular prenatal care and ultrasounds.

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Conclusion

Antidepressants can be effective in treating and managing depression, but they may also have potential side effects that can impact fertility in both males and females. It is crucial to discuss the risks & benefits of antidepressant treatment with a doctor, particularly for women who are pregnant or trying to conceive. By exploring various treatment options, adjusting medications if necessary, and closely monitoring the health of the mother and developing foetus, individuals can make informed decisions about managing depression while preserving their fertility goals.

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