Male fertility: psychiatric considerations

ObjectiveTo examine: 1) current knowledge on normal biologic variation of seminal parameters; 2) how stress and psychological factors affect sperm quality in fertile and infertile males; and 3) how mental illness and psychopharmacologic agents can affect male fertility.DesignEnglish-language Medline, Embase, and Psycinfo were searched for relevant publications (from 1970 to January 2011) for systematic review.SettingNone.Patient(s)None.Intervention(s)None.Main Outcome Measure(s)Possible effects of stress, mood, and psychotropic medications on male factor fertility.Result(s)Male-factor infertility is influenced by myriad factors (obesity, tobacco, etc.). Stress alone may reduce testosterone levels and spermatogenesis. Infertility assessment and treatment can lead to distress and negatively affect sperm samples. Available research has failed to control for potentially confounding variables.Conclusion(s)Although some trends have been identified, larger-scale studies that adequately control all confounding variables are needed before conclusions can be made about the relationship between stress, psychotropic agents, and male infertility.