Anxiety, depression and antidepressant use in men have no impact on IVF outcomes

Live birth rates were similar for male partners of women undergoing IVF and ICSI, with or without depression and anxiety.

Men with high anxiety scores were found to have lower sperm motility, but there were no significant differences in the IVF outcomes and live birth rates, a study of a cohort of 222 male partners of women accessing fertility treatment published in Human Reproduction found. While erectile dysfunction and libido were affected by anxiety and depression, these factors, alongside antidepressant use, did not affect fertility treatment outcomes.

Lead author Dr Zachary Walker, from Brigham and Women's Hospital, Boston, Massachusetts, said: 'Our findings indicate that despite past concerns over antidepressant medication's impact on fertility, treatment should not be withheld from men experiencing anxiety or depression'.

Researchers conducted a survey-based retrospective cohort study that found that 22.5 percent of male partners of women accessing fertility treatment had high anxiety scores, and 6.5 percent had high depression scores. Antidepressant use was higher in both groups. Men with depression were found to have similar final total motile sperm counts and live birth rates compared to men with lower depression scores.

As the results show no significant differences in sperm parameters and respective treatment outcomes, Dr Walker said: 'There's debate among fertility specialists about prescribing antidepressants during IVF due to potential fertility impacts. However, stress itself can alter hormones, sometimes leading to a condition called hypogonadotropic hypogonadism, where the brain tells our reproductive organs to shut down because we are too stressed to conceive.'

'So, while anxiety medication can hinder fertility, so can stress. Given that IVF is notoriously stressful, our findings underscore the importance of prioritising patient mental health during fertility treatment.'

However, the authors acknowledged that the small sample size of men with depression was one of the limitations of the study, as was the lack of ancestral diversity of participants – most were white – and the lack of sperm morphology assessment during treatments.

Despite this, the study provided useful insights about the effects of antidepressants on male fertility said one of the authors, Dr Martin Kathrins, assistant professor of surgery at Harvard Medical School, Cambridge, Massachusetts: 'Based on this study, I would encourage my patients to pursue and continue appropriate therapies for anxiety and depression without concern that they will adversely impact their IVF outcomes.'

Further studies will focus on monitoring patients' hormone levels to understand the impact of stress during IVF treatments.