From the FDA Drug Label
Carcinogenesis, Mutagenesis, Impairment of Fertility There is no evidence of carcinogenicity or mutagenicity from in vitro or animal studies. Impairment of fertility in adult animals at doses up to 12.5 mg/kg/day (approximately 1. 5 times the MRHD on a mg/m2 basis) was not observed. Impairment of fertility — Two fertility studies conducted in adult rats at doses of up to 7.5 and 12. 5 mg/kg/day (approximately 0.9 and 1.5 times the MRHD on a mg/m2 basis) indicated that fluoxetine had no adverse effects on fertility
The FDA drug label does not provide direct information on the effect of fluoxetine on human sperm. However, it does mention that impairment of fertility in adult animals was not observed at doses up to 12.5 mg/kg/day.
- Key points:
- No adverse effects on fertility were observed in animal studies.
- The label does not provide direct information on the effect of fluoxetine on human sperm. 1
From the Research
Fluoxetine can potentially affect sperm and male fertility, with evidence suggesting it may decrease progressive motility and promote fluctuations in ROS levels and sperm capacitation, as seen in the most recent study from 2025 2. The mechanism involves fluoxetine's impact on serotonin levels, which can influence hormonal regulation in the reproductive system. Some men taking fluoxetine experience sexual side effects including decreased sperm count, reduced sperm motility, and abnormal sperm morphology. These effects are typically reversible after discontinuing the medication. Key points to consider:
- Fluoxetine's effects on sperm parameters, such as motility and count, have been observed in both human and animal studies 2, 3, 4, 5, 6.
- The impact of fluoxetine on male fertility may be related to its effects on epididymis contraction, sperm transit time, and testicular tissue 4, 6.
- Alternative antidepressants may have fewer reproductive effects, and men planning conception should discuss medication options with their doctor 5.
- The benefits of treating depression often outweigh potential fertility concerns, but it's essential to weigh these factors and consider individual circumstances 2, 5.