Objective : This narrative review evaluates current evidence regarding the impact of paternal selective serotonin reuptake inhibitor (SSRI) use on male fertility parameters and neonatal outcomes.
Material and Methods: A comprehensive search of PubMed/MEDLINE and Web of Science databases was conducted for studies published up to December 2025. Out of 132 screened records, 13 studies investigating common SSRIs (e.g., sertraline, citalopram, escitalopram, fluoxetine, paroxetine, fluvoxamine) and newer agents (vortioxetine, vilazodone) were included in the narrative synthesis.
Results: Evidence indicates that SSRIs may cause transient impairments in sperm motility, morphology, and DNA integrity, which are generally reversible following treatment discontinuation. Large-scale cohort studies demonstrate no significant association between paternal SSRI use and major congenital malformations, low Apgar scores, or small-for-gestational-age (SGA) births. While a modest increase in preterm birth risk was noted, this is likely attributable to confounding by the underlying paternal psychiatric condition rather than direct pharmacological exposure. Similarly, associations with neurodevelopmental outcomes, such as Autism Spectrum Disorder (ASD) and Attention Deficit/Hyperactivity Disorder (ADHD), are more likely explained by paternal psychiatric conditions rather than direct drug exposure.
Conclusion: Paternal SSRI use does not appear to pose a significant risk to clinical fertility or offspring health. Given the transient nature of semen abnormalities, treatment should be tailored individually to balance psychiatric stability and reproductive goals.
Keywords: infertility, male, paternal exposure, pregnancy, selective serotonin reuptake inhibitors, teratogens
Abstract
Objective : This narrative review evaluates current evidence regarding the impact of paternal selective serotonin reuptake inhibitor (SSRI) use on male fertility parameters and neonatal outcomes.
Material and Methods: A comprehensive search of PubMed/MEDLINE and Web of Science databases was conducted for studies published up to December 2025. Out of 132 screened records, 13 studies investigating common SSRIs (e.g., sertraline, citalopram, escitalopram, fluoxetine, paroxetine, fluvoxamine) and newer agents (vortioxetine, vilazodone) were included in the narrative synthesis.
Results: Evidence indicates that SSRIs may cause transient impairments in sperm motility, morphology, and DNA integrity, which are generally reversible following treatment discontinuation. Large-scale cohort studies demonstrate no significant association between paternal SSRI use and major congenital malformations, low Apgar scores, or small-for-gestational-age (SGA) births. While a modest increase in preterm birth risk was noted, this is likely attributable to confounding by the underlying paternal psychiatric condition rather than direct pharmacological exposure. Similarly, associations with neurodevelopmental outcomes, such as Autism Spectrum Disorder (ASD) and Attention Deficit/Hyperactivity Disorder (ADHD), are more likely explained by paternal psychiatric conditions rather than direct drug exposure.
Conclusion: Paternal SSRI use does not appear to pose a significant risk to clinical fertility or offspring health. Given the transient nature of semen abnormalities, treatment should be tailored individually to balance psychiatric stability and reproductive goals.
Keywords: infertility, male, paternal exposure, pregnancy, selective serotonin reuptake inhibitors, teratogens