Depression and semen quality

Ye et al. (1Ye Y.-X. Chen H.-G. Sun B. Chen Y.-J. Duan P. Meng T.-Q. et al.Associations between depression, oxidative stress, and semen quality among 1000 healthy men 2 screened as potential sperm donors.Fertil Steril. 2022; 117: 86-94Abstract Full Text Full Text PDF Scopus (1) Google Scholar) present valuable data on the association of semen parameters with self-reported depression scores as measured on the Beck Depression Inventory (BDI). As an observational study, there are obvious limitations of the data and its interpretation. Since the study subjects had specific exclusions, the study population does not necessarily reflect the population as a whole, an important caveat. The subjects in the study population specifically were excluded if they had a clinical diagnosis of depression. Interestingly, BDI measurements indicated that at least mild depression was present in 47.7% of the study group, a remarkably high proportion of any population of healthy men, suggesting either overdiagnosis of depression or a very high population prevalence of this condition. Study of semen parameters of those men with a clinical diagnosis of depression who were excluded from this study would also have been very useful, although such an investigation would also have to consider the effects of some antidepressant medications on semen quality that have previously been documented (2Tanrikut C. Feldman A.S. Altemus M. Paduch D.A. Schlegel P.N. Adverse effect of paroxetine on sperm.Fertil Steril. 2010; 94: 1021-1026Abstract Full Text Full Text PDF PubMed Scopus (125) Google Scholar).Throughout the article (1Ye Y.-X. Chen H.-G. Sun B. Chen Y.-J. Duan P. Meng T.-Q. et al.Associations between depression, oxidative stress, and semen quality among 1000 healthy men 2 screened as potential sperm donors.Fertil Steril. 2022; 117: 86-94Abstract Full Text Full Text PDF Scopus (1) Google Scholar), the investigators reference “semen quality parameters.” It is important for the reader to note that sperm count/concentration, motility, and morphology are semen parameters and do not necessarily reflect male fertility or male reproductive potential. More importantly, semen parameters are not a diagnostic test of sperm quality (3Schlegel P.N. Sigman M. Collura B. De Jonge C.J. Eisenberg M.L. Lamb D.J. et al.Diagnosis and treatment of infertility in men: AUA/ASRM guideline part I.Fertil Steril. 2021; 115: 54-61Abstract Full Text Full Text PDF PubMed Scopus (67) Google Scholar). Similarly, it is not accurate to refer to alterations in semen parameters as reflecting “impaired male reproductive health.”The observations in this study classified men with abnormal BDI scores as having mild, moderate, or severe depression and evaluated the interaction between semen parameters and severity of depression. Since only 19 men were classified as having severe depression, this small subset of men may have skewed the analysis of investigating the relationship between the severity of depression and semen parameters. It is unclear how 19 men with severe depression had no clinical diagnosis of a mental disorder. The use of urinary measures of oxidative stress in this study is curious, since seminal measurement of oxidative stress would have been possible in these men and more relevant for the detection of an interaction between oxidative stress that could affect sperm quality and semen parameters.In summary, the study shows a relationship between depression and its severity, with semen parameters. Since this is an observational study, it is not possible to determine whether this correlation is a causal relationship. Ye et al. (1Ye Y.-X. Chen H.-G. Sun B. Chen Y.-J. Duan P. Meng T.-Q. et al.Associations between depression, oxidative stress, and semen quality among 1000 healthy men 2 screened as potential sperm donors.Fertil Steril. 2022; 117: 86-94Abstract Full Text Full Text PDF Scopus (1) Google Scholar) present valuable data on the association of semen parameters with self-reported depression scores as measured on the Beck Depression Inventory (BDI). As an observational study, there are obvious limitations of the data and its interpretation. Since the study subjects had specific exclusions, the study population does not necessarily reflect the population as a whole, an important caveat. The subjects in the study population specifically were excluded if they had a clinical diagnosis of depression. Interestingly, BDI measurements indicated that at least mild depression was present in 47.7% of the study group, a remarkably high proportion of any population of healthy men, suggesting either overdiagnosis of depression or a very high population prevalence of this condition. Study of semen parameters of those men with a clinical diagnosis of depression who were excluded from this study would also have been very useful, although such an investigation would also have to consider the effects of some antidepressant medications on semen quality that have previously been documented (2Tanrikut C. Feldman A.S. Altemus M. Paduch D.A. Schlegel P.N. Adverse effect of paroxetine on sperm.Fertil Steril. 2010; 94: 1021-1026Abstract Full Text Full Text PDF PubMed Scopus (125) Google Scholar). Throughout the article (1Ye Y.-X. Chen H.-G. Sun B. Chen Y.-J. Duan P. Meng T.-Q. et al.Associations between depression, oxidative stress, and semen quality among 1000 healthy men 2 screened as potential sperm donors.Fertil Steril. 2022; 117: 86-94Abstract Full Text Full Text PDF Scopus (1) Google Scholar), the investigators reference “semen quality parameters.” It is important for the reader to note that sperm count/concentration, motility, and morphology are semen parameters and do not necessarily reflect male fertility or male reproductive potential. More importantly, semen parameters are not a diagnostic test of sperm quality (3Schlegel P.N. Sigman M. Collura B. De Jonge C.J. Eisenberg M.L. Lamb D.J. et al.Diagnosis and treatment of infertility in men: AUA/ASRM guideline part I.Fertil Steril. 2021; 115: 54-61Abstract Full Text Full Text PDF PubMed Scopus (67) Google Scholar). Similarly, it is not accurate to refer to alterations in semen parameters as reflecting “impaired male reproductive health.” The observations in this study classified men with abnormal BDI scores as having mild, moderate, or severe depression and evaluated the interaction between semen parameters and severity of depression. Since only 19 men were classified as having severe depression, this small subset of men may have skewed the analysis of investigating the relationship between the severity of depression and semen parameters. It is unclear how 19 men with severe depression had no clinical diagnosis of a mental disorder. The use of urinary measures of oxidative stress in this study is curious, since seminal measurement of oxidative stress would have been possible in these men and more relevant for the detection of an interaction between oxidative stress that could affect sperm quality and semen parameters. In summary, the study shows a relationship between depression and its severity, with semen parameters. Since this is an observational study, it is not possible to determine whether this correlation is a causal relationship. Associations between depression, oxidative stress, and semen quality among 1,000 healthy men screened as potential sperm donorsFertility and SterilityVol. 117Issue 1PreviewTo explore the association between depression and semen quality and the mediating role of oxidative stress. Full-Text PDF