Impact of depression and the potential effect of its treatment on semen parameters

Abstract

Up to 30% of male infertility may be idiopathic. Researchers are looking into psychological problems, particularly depression, as possible risk factors for such idiopathic etiology. We aimed to assess how depression affects Egyptian patients’ semen parameters and its indicators for male fertility and to evaluate the potential positive influence of improving the score of depression on these parameters. A prospective observational pilot clinical study included twenty-one male patients with moderate, severe, or very severe depression. They were subjected to baseline semen analysis. All patients were treated by serotonin and norepinephrine reuptake inhibitors (SNRIs). Those who showed improvement in their depression, within the following 6 months, were eligible for a second evaluation of their semen. We compared baseline semen parameters of all patients to 2021-WHO lower normal limit as well as post-improvement values. Only 16 patients showed improvement in their depression after treatment with SNRIs and were candidates for the 2nd assessment of semen analysis. No significant improvements could be detected except for volume. Yet, on repeating the comparisons including only patients with abnormal baseline semen parameters, significant improvements were observed in most semen parameters, including semen volume, sperm count per ejaculate, and percentage of sperm motility either progressive or total. The results addressed the potential impact of depression on male fertility in a sample of Egyptian patients through a negative effect on semen parameters. This effect is neither sole nor direct and may require either predisposed individuals or the existence of other co-factors to be manifested. However, the appropriate treatment of depression may reverse such effects and help in the management of male infertility.