New research suggests that a man's poor mental state can affect the ability of a couple to conceive.
Researchers at the National Institutes of Health combined data from two previous studies that compared the effectiveness of ovulation-inducing drugs in women with polycystic ovary syndrome and couples with unexplained fertility. Most of the 1,650 women and 1,608 men involved in the dataset formed couples.
Based on the results of a questionnaire, about 6% of women and 2% of men were rated as having major depression, and this was found to have a major impact on fertility. Men with major depression were 60% less likely to have a live birth compared to men who did not have major depression. The study did not include couples who underwent in vitro fertilization since the procedure couple potentially offset some of the effects of depression.
Of the 34 men with major depression, only three achieved a live birth. That's compared to nearly 25% of couple who achieved a live birth, where the male partner did not have major depression.
Depression may affect fertility in men in a number of ways, including sexual dysfunction due to reduced libido and negative change in sperm quality. For instance, a study published in 2014 found that men who had gone through two or more stressful events the previous year had lower sperm motility and a lower percentage of normal sperm. Stress also lowered testosterone levels, which is a hormone known to be heavily involved in fertility.
Previously, studies had shown that depression negatively affects fertility in women. For instance, 41 percent of women seeking fertility treatments have symptoms of depression. The present study is the first to show that depression also affects male fertility, providing "new information to consider when making treatment decisions.”
A secondary finding of the study was that a class of antidepressants known as non-selective serotonin reuptake inhibitors (non-SSRIs) was linked to a higher risk of early pregnancy loss among females being treated for infertility. SSRIs, another class of antidepressants, were not linked to pregnancy loss.
Scientific reference: Emily A. Evans-Hoeker et al. Major depression, antidepressant use, and male and female fertility, Fertility and Sterility (2018). DOI: 10.1016/j.fertnstert.2018.01.029.