Associations between depression, oxidative stress, and semen quality among 1,000 healthy men screened as potential sperm donors

In a cross-sectional study with repeated measures of semen quality in Chinese male sperm donors, depression was associated with worse semen quality parameters.

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VOLUME 117, ISSUE 1, P86-94


Yi-Xiang Ye, M.B.B.S., Heng-Gui Chen, Ph.D., Bin Sun, M.B.B.S., Ying-Jun Chen, Ph.D., Peng Duan, Ph.D., Tian-Qing Meng, M.D., Cheng-Liang Xiong, M.D., Yi-Xin Wang, Ph.D., An Pan, Ph.D. 



To explore the association between depression and semen quality and the mediating role of oxidative stress.


Cross-sectional study with repeated measures of semen quality.


Human Sperm Bank of Hubei Province, People’s Republic of China.


From April 2017 to July 2018, we recruited 1,000 potential sperm donors who completed the Beck Depression Inventory questionnaire and had measures of oxidative stress biomarkers.



Main Outcome Measure(s)

Severity of depression was evaluated by the Beck Depression Inventory scores (0–4, no depression; 5–13, mild depression; 14–20, moderate depression; and 21 or greater, severe depression). The urinary concentrations of 8-hydroxy-2-deoxyguanosine, 4-hydroxy-2-nonenal-mercapturic acid, and 8-iso-prostaglandin F (8-isoPGF) were measured to reflect oxidative stress status. Repeated semen quality parameters (n = 5,880) were examined by trained professional technicians according to the World Health Organization laboratory manual. Associations between depression, oxidative stress, and repeated measures of semen quality parameters were evaluated using linear or mixed-effects models with adjustment for potential confounders. Mediation analysis was performed to test the potential mediating role of oxidative stress.


A total of 391 (39.1%) men were classified as mild depression, 67 (6.7%) as moderate depression, and 19 (1.9%) as severe depression. Inverse dose–response relationships between severity of depression and semen quality parameters were found. Compared with men without depression (n = 523), those with severe depression had a 25.26% (95% confidence interval, −38.65%, −8.93%) lower semen volume, 37.04% (−55.37%, −11.20%) lower total sperm count, 13.57% (−23.17%, −2.78%) lower total motility, and 15.08% (−25.09%, −3.72%) lower progressive motility; men with moderate depression also had a 12.28% (−21.16%, −2.40%) lower semen volume and 23.56% (−36.50%, −7.97%) lower total sperm count. We found a positive dose–response relationship between severity of depression and urinary 8-isoPGF concentrations. However, we found no evidence that the associations between depression status and semen quality were mediated by oxidative stress markers.


In the study of Chinese male sperm donors, men with depression had worse semen quality parameters, including semen volume, sperm concentration, total sperm count, total motility, and progressive motility. Although depression was positively associated with urinary 8-isoPGF concentrations, depression–semen quality associations were not mediated by oxidative stress.

Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders.