Low sperm count and antidepressants

[Bippy00]

I am new to mumsnet (signed up today) however I have been reading over threads regarding this for months.
Me and my boyfriend had been TTC and the whole time he had been taking antidepressants 15mg Mirtazapine daily for anxiety and stress.
At the 10 month mark we decided to see a doctor everything came back normal for me but for him it was awful!
his sperm results were- 0.5 million per ml ( normal is 15 million above)
mortility 8% ( normal is above 40%)
morthology 2%(normal is 4% or above)

The news shattered us and we were heart broken.
Anyway… he was advised to stop the antidepressants and have a repeat test in 3 months.
We got the results a couple of weeks ago and although still below the normal ranges things have improved significantly (apart from morthology) -
sperm per ml- 9.8 million
mortility- 48%
morthology-1.5%

Our fertility clinical have still said we will require ivf icis with these results. However the amount they have improved is over 1000%. Has anyone been in the same situation? Do you think it was the antidepressant causing the problem? Could things could improve more?

Hi, it depends how fast you want things to move really, like age etc. Clearly the antidepressants were having a negative effect to see those results improve, so if you have time and want to wait and see while TTC naturally then could be worth it.

My husband and I had IVF with ICSI due to low sperm count caused by a varicocele and were successful first round, his parameters were lower than your DHs second test so it's not the end of the world if you have to go for ICSI. Might be worth getting the ball rolling asap with IVF referrals though as they takes aaaages and can try naturally in the meantime, rather than try for 6 months and not conceive then have to wait for lengthy referrals when time is more precious.

My husband and I also went down the IVF route after anti depressants nuked his sperm - even though doctors swore blind it didn't happen even though I printed off all the research that indicated it did! Anyway wait lists were long so tried naturally in the meantime - ended up falling pregnant naturally about a year after he came off the drugs and a week before starting IVF

Thank you so much for your replies.

I’m glad you both got your BFP in the end.
I feel a bit more confident about things now, I do think that we will still push for the ivf as I agree we don’t want to waste any more time and can try naturally in the mean time.
Although IVF really does scare me.

@isthistheendtakeabreath when I asked the doctor if it was the antidepressant that made such an impact she didn’t really comment and said it could be a factor of things. It’s strange how doctors are reluctant to blame the tablets.

But if the antidepressant were the cause I’m wondering why morphology didn’t improve and if they will get any better.
the doctor did say there’s nothing we can really do to improve morphology though.. so maybe not

I don't think they want to admit that it is a side effect because of the implications....plus a well known side effects it's also decreased libido and ejaculation issues

Morphology is actually something you can improve? Did your doctor tell you differently? It's very sensitive to environment / diet / too hot / too cold/ tight clothing/ drinking and smoking even if he has had a cold 3 months ago. Once off the AD my husbands sperm ranged from 1% to 6% (I know as we ended up doing multiple round of IVF to conceive a second child)

I'd stick him on a really good multi vitamin like Proceive Max for Men overhaul your diet and environment like no smoking reduced drinking no really hot baths for him - stop wearing Lycra and cycling if he's into that 😂

Yes she said that there isn’t much we can do about the low morphology, however after googling as soon as I got home it does say different online so I was a bit confused. It’s reassuring to hear from you that your partners morphology did change.

if you don’t mind me asking, did all his other perimeters go up to normal range after the AD ?

my boyfriend doesn’t smoke, hardly drinks and only has showers and I have got him on a load of vitamins and veg every day. So hoping this will improve things

Yes it took about a year but his sperm returned to "normal" parameters - some of his morphology on occasion was low and other times well within normal range.

I admit I was sooo bloody annoyed when he went on ADs - he only went to the doctors with flu like symptoms and got told he was depressed! Then when I read up about them and the effect it would have on TTC I admit I became really quite stressed about the whole thing!

It seems they are given out way too easy now a days without any real warning of the side effects.
When we first started TTC I did mention to my boyfriend a number of times that it could be effecting his fertility. But he was adamant it had no effect and wouldn’t listen to me. And then when we got the result he was really kicking himself for ever going on them in the first place.

I’m just praying that within time the results will get within normal range, I’m so pleased to hear that this was the case for you even if it was a year.
I am becoming very obsessed and spend all the time researching things about low sperm count on google, I guess only time will tell.

My DH came off antidepressants and his results went up as well.

Still not good enough for us to conceive naturally, but there was a vast improvement after coming off them.

@SnapDragon5 do you mind me asking how long has he been off of the antidepressants?

@Bippy00 It improved within 3 months of coming off them, so not too long.

Sadly though it still wasn't enough for us to be successful with ICSI/ IVF. We've moved to a donor now (other underlying health issues are the main cause for us and they won't change).

Really interesting to read this thread as I’ve been wondering about experiences with ADs (specifically Sertraline) and sperm. For those who have posted it doesn’t sound like it was a difficult decision to have come off them, though - it would be big for us. Can I ask, did you struggle with conceiving or carrying to term? I’ve had 2 MCs since DH started on ADs, one successful pregnancy before, and wondering whether there’s a link. We conceive easily but it’s not sticking… And were the male factor tests you took all through GP or private? I’ve been reading a bit about DNA fragmentation in sperm as a result of ADs too, but doesn’t seem that’s a standard NHS test. Grateful for any thoughts!

@Oxalis00

I lost my first pregnancy at 12 weeks but the second one stuck and became my daughter
X

@Oxalis00

sorry to hear about your MC’s. My partner point blank refused to come off of them until we got his results back. He was so upset with the results he didn’t even question coming off of them after that. He was on them due to work stress, and since coming off of them he stepped down in his job, but I completely understand everyone’s situation is different and would be a lot more difficult for some people.

Both his tests were done through his GP on the NHS. However they do not test for DNA fragmentation I believe this can only be done privately.

It seems that if AD can impact all other sperm parameters so much then it’s likely they will impact DNA fragmentation too,
however if you partner has normal sperm parameters (which is likely to be the case as your fallen pregnant twice) then maybe the AD don’t impact him in this way

Hi @Bippy00 how are you getting on? Any progress yet? 🤞🏻🤞🏻🤞🏻 I just saw a documentary called ‘Celebrity Save Our Sperm’ and it shows lots of ways you can improve sperm count. I know you’ve already tried lots, but there might be more ideas on there. Other things I’ve heard:

• no polyester below the waist
• cool the balls as much as poss
• no tight trousers/pants
• eat walnuts
• no drinking etc
• no weedkiller/cleaning chemicals
• no marachino cherries
• take all the supplements, eg fenugreek
• switch to fat free dairy (for him, not you)
• b12, coQ10, vit C, ashgawandha, d-aspartic acid
• don’t use plastic containing bpa

@FoodFann we had a 3rd semen analysis and got the results a few days ago over the phone. The count has gone back down to 3 million, didn’t asked the other numbers as I was too emotional. The consultant has said we should push onto ivf now and he is arranging an appointment for us to sign the paper work to get the ball rolling.

thank you for your suggestions I have tried a lot of these but there is a couple on the list I will also try…

Really struggling with it all at the moment trying to stay hopeful but it’s so hard

Therapy sorry to hear your latest update @Bippy00 - this is after stopping the ADs a while back now, isn’t it? I know it must be a lot to take in, once you start to think about everything that could be ahead (IVF etc) and how far that is from what you dreamed of. Sending sympathy and good luck for the next step. Sounds like your consultant is being proactive which is something.

@Oxalis00 Thankyou,
Yes he stopped the antidepressants about 8 months ago now.
very disheartening but I think we have accepted now that the only way forward is ivf with icsi. And trying my best to stay positive.