Paxil and getting pregnant

My husband and I are trying to have kids. We have been trying for only a few month, however, we are not young anymore (35) and I don't want to wait a year before consulting with a doctor (as it usually recommended). So here is my question:
My husband has been taking paxil for the past 13 years (10mg). From the research online I found out that paxil changes sperm DNA that reduces permeability and as a result reduces the chance for pregnancy.
I just want to know if there are men out there who've been taking paxil and also got kids? Did they have to switch from paxil to something else? Did they have to take specific supplements?
Please advise. My clock is ticking and I don't like to be in the dark
Thank you

[Abhijeet Deshmukh, MD]

Hello.

There are a few recent studies which point towards an association between Paxil use and possible reduced fertility. However, these study results are not robust. Larger sample studies and controlled trials are needed to prove that Paxil use definitely reduces fertility. The studies so far have not actually tested for fertility. Paroxetine does have an effect on the DNA fragmentation of sperms. As a result, the researchers point towards a potential effect on fertility.

The obvious option would be to try and stop Paxil. Since your husband has been on Paxil since a long time, it might be difficult for him to stop it. He also needs to judge his clinical symptoms before deciding to taper off Paxil. Symptoms of the condition for which he is taking Paxil, might re-appear or increase after stopping it. You will have to weigh the risks against the benefits. I won't be able to suggest if Paxil should be stopped, as I have not examined him personally. But if you do decide to stop it, the best way to do is taper it off gradually and watch for any symptoms of discontinuation syndrome (also called withdrawal). He might try another class of medication as an alternative to Paxil.

[tanross]

Hello Dr. Abhijeet,

I know that Paxil can impact the DNA impairment of the semen and as a result the motility and permeability can be slow down that can resolve in infertility. And I know that there is only small number of studies there that provide this information

I just want to know if there are men there that taking paxil and have kids while on the pill. Did they take supplements, if so, what are they. What can help without stopping taking paxil (I would never consider that knowing my Husband moods etc.). I also know that switching paxil for even zyprexa is not an easy task.

I would like to hear about some statistics that out there that can tell me that we have some chance of having children.

Thank you

  

[Abhijeet Deshmukh, MD]

Hello.

I understand your concern. And I can see you have done some good research on this topic. In my previous post, I have tried to suggest that even though Paxil is known to affect the DNA fragmentation, it reduces the fertility only up to a certain percentage. And since there have not been any actual follow-up fertility studies to prove the actual impact, I won't be able to give you the exact answer. In view of a lack of clear evidence, it is safe to consider that fertility is affected, but only up to a certain extent.

If we try to break the issue down to the basic question "whether the sperms are able to fertilize the ovum", the following link may help a bit. (Since Paxil is not known to affect other semen parameters)

http://www.ncbi.nlm.nih.gov/pubmed/19423105

Based on the available resources, I can say that you do have more than some chance of having children. I suggest you also consult Dr Elaine Brown, on the Fertility/Infertility Forum. Here's the link - http://www.medhelp.org/forums/Fertility---Infertility/show/215

I hope you get your answers soon.

Best Regards