Adverse effect of paroxetine on sperm

Fertil Steril. 2010 Aug;94(3):1021-6. doi: 10.1016/j.fertnstert.2009.04.039. Epub 2009 Jun 10.


Objective: To assess the effects of a selective serotonin reuptake inhibitor on semen parameters.

Design: Prospective study.

Setting: Academic medical center.

Patient(s): Thirty-five healthy male volunteers, 18-65 years old.

Intervention(s): Paroxetine administration for 5 weeks.

Main outcome measure(s): Serum hormone levels, semen analyses, percent sperm DNA fragmentation, and questionnaire assessment of sexual function assessed before, during, and 1 month after drug administration.

Result(s): Mean sperm DNA fragmentation was significantly higher for men while on paroxetine (30.3%) versus baseline (13.8%). Before paroxetine, 9.7% of patients had a terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) score>or=30% compared with 50% at week 4 of treatment. The odds ratio (OR) of having abnormal DNA fragmentation while taking paroxetine was 9.33 (95% confidence interval, 2.3-37.9]. Multivariate logistic regression correcting for age and body mass index confirmed this correlation (OR, 11.12). Up to 35% of men noted significant changes in erectile function and up to 47% of men reported ejaculatory difficulties on medication. Recovery to near-normal sexual function was noted after stopping treatment. Standard semen parameters were not significantly altered during paroxetine treatment.

Conclusion(s): In men with normal semen parameters, paroxetine induced abnormal sperm DNA fragmentation in a significant proportion of subjects, without a measurable effect on semen parameters. The fertility potential of a substantial number of men on paroxetine may be adversely affected by these changes in sperm DNA integrity.

Publication types

  • Controlled Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antidepressive Agents, Second-Generation / administration & dosage
  • Antidepressive Agents, Second-Generation / adverse effects
  • Cell Shape / drug effects
  • DNA Fragmentation / drug effects
  • Dose-Response Relationship, Drug
  • Humans
  • Male
  • Middle Aged
  • Paroxetine / administration & dosage
  • Paroxetine / adverse effects*
  • Semen Analysis
  • Spermatozoa / cytology
  • Spermatozoa / drug effects*
  • Spermatozoa / physiology
  • Young Adult


  • Antidepressive Agents, Second-Generation
  • Paroxetine