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While SSRIs are efficacious, their safety profile in terms of reproductive system toxicity remains controversial, especially in developing adolescents, fertile adults, and perinatal pregnant women ( 2 Effects of SSRIs on reproductive cytogenesis 2.1 Effects of SSRIs on male germ cells Several studies have found that fluoxetine disrupts the hypothalamus–lobe–testis axis, significantly decreasing the serum concentrations of luteinizing hormone (LH), follicle stimulating hormone (FSH), progesterone, and testosterone, while also affecting several sperm quality parameters, as evidenced by decreased sperm concentrations and viability, increased deoxyribonucleic acid (DNA) fragmentation, and lower reproductive organ weights (Figure 1), which could have been attributed to diminished androgen levels
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