Last Updated on February 3, 2026
Quick answer: does Lexapro affect fertility?
For women, there is no strong proof that Lexapro causes ongoing trouble getting pregnant. For men, some studies in the wider SSRI group link use to lower sperm count or movement, but results vary and may improve after the drug is stopped.
The most common way Lexapro affects “fertility” is indirect. If it lowers sex drive or delays orgasm, conception can take longer, even if hormones and egg health are normal.
Quick points to remember
- Lexapro is not known to cause permanent infertility in most people.
- Sex side effects are common and can slow down trying to conceive.
- If sperm health is a concern, testing can give real numbers instead of guesses.
- Never stop suddenly without a plan, especially if symptoms were severe.
If you are dealing with alcohol or drug use at the same time, that can also lower the odds of pregnancy and raise health risks. For a medically supported first step, you can learn about Austin detox.
Why Lexapro can affect family-planning even without “infertility”
People often use one word—fertility—to describe several different goals. It helps to separate them, because Lexapro affects each one in a different way.
- Sex and timing: changes in desire, arousal, orgasm, or ejaculation can reduce how often sex happens during the fertile window.
- Conception: ovulation, sperm health, and fallopian tube function help sperm meet egg.
- Pregnancy health: once pregnant, the focus shifts to symptom control, safety, and newborn effects.
It is also worth naming the mental health side of the equation. Untreated depression and anxiety can reduce sex drive, disrupt sleep, and raise stress hormones. Over time, that can affect cycles and sperm health, and it can also lead to more drinking or drug use.
Some people notice sex side effects soon after starting Lexapro, while others notice them after a dose change. For many, side effects fade over time. For others, they do not, and that is when a medication review helps most.
Alcohol can also affect sex drive, sperm health, and cycle regularity. If you are wondering about drinking while on Lexapro, this guide may help: Lexapro and alcohol risks.
What research suggests about Lexapro and getting pregnant
There are not many high-quality studies that follow people trying to conceive naturally while taking Lexapro. Because of that, experts often look at two types of data: lab findings and outcomes from people going through IVF.
What the research shows so far
- Some lab and animal work suggests certain SSRIs may affect parts of the reproductive system. These findings do not always translate to real-world pregnancy rates.
- In IVF studies, several reports have found similar pregnancy and live birth rates in people who did and did not use SSRIs, while other studies show small differences that may be explained by the underlying mental health condition.
A PubMed review that summarizes both male and female findings notes possible effects in some settings, but also describes IVF studies where SSRI treatment did not show a clear drop in success rates.
Read the abstract here: The effects of SSRIs on male and female fertility (PubMed).
How to apply this if you are trying to conceive
- If your cycles are regular and you have no known fertility diagnosis, Lexapro is not usually the first thing doctors blame.
- If sex side effects are the biggest barrier, ask about dose timing, dose changes, or a different medicine.
- If you are over 35 or have been trying for many months, ask for a full workup instead of guessing.
- If you are in fertility treatment, make sure your mental health prescriber and fertility team share the same plan.
Lexapro and male fertility: what’s known about sperm changes
For men, the main concern is sperm quality. Across SSRI studies, some people have shown lower sperm count, less sperm movement, or changes in shape. Other studies show no change.
One reason results vary is that many studies are small and include different doses, time frames, and health histories. Stress, sleep loss, alcohol, cannabis, and tobacco can also harm sperm, which makes it harder to isolate one cause.
Even when sperm changes happen, many reports suggest they can improve after stopping the SSRI. Keep in mind that sperm take time to develop. A semen test often reflects the last two to three months, not only the last few days.
Stopping suddenly can trigger withdrawal symptoms and a return of anxiety or depression. That can also affect sex and relationship health during a time that is already stressful.
If you are considering a change, do not stop on your own. Our Lexapro guide explains why slow dose reductions are safer and what withdrawal can feel like: Lexapro withdrawal support.
Simple questions to bring to your appointment
- “We want to try for a baby in the next few months. Is my dose the lowest effective dose?”
- “Would therapy, sleep work, or stress support let me stay stable with less medicine?”
- “Should we check a semen test so we have real numbers to work with?”
- “If we switch medicines, how long should we wait before retesting?”
Does Lexapro affect birth control? Lexapro and birth control basics
Many people ask: does Lexapro affect birth control? In general, SSRIs like Lexapro are not known to make hormonal birth control stop working. Most “pill failure” drug interactions come from medicines that strongly change liver enzymes.
Still, day-to-day issues matter. If Lexapro causes nausea or stomach upset, missed pills or vomiting after a pill can raise pregnancy risk. If you have trouble keeping pills down, talk with your doctor about a different birth control method.
Also consider the mood side. Some people notice mood changes on hormonal birth control. Others feel steadier. If you are changing both birth control and antidepressants at once, it can be hard to tell what is causing what, so take notes and share them with your doctor.
For a plain-language overview of escitalopram side effects, warnings, and what to tell your doctor about other medicines, see: Escitalopram drug information (MedlinePlus).
Lexapro and pregnancy: is Lexapro safe for pregnancy?
“Is Lexapro safe for pregnancy?” is a common and reasonable question. The honest answer is that every pregnancy is different, and the decision is usually about balancing risks.
Untreated depression and anxiety can raise risks during pregnancy too, especially if symptoms lead to poor sleep, missed prenatal care, or substance use. For many people, staying stable is a health goal for both parent and baby.
At the same time, SSRI exposure late in pregnancy has been linked with short-term newborn symptoms in some cases. These can include irritability, tremor, feeding problems, or breathing trouble. Many babies do well with monitoring, but planning ahead helps.
Federal labeling for escitalopram notes possible newborn effects, especially with third-trimester use, and recommends a clinician-guided plan. The label also discusses breastfeeding and advises watching the baby for sleepiness or feeding problems.
You can review the pregnancy and breastfeeding warnings here: Escitalopram label information (DailyMed).
If pregnancy planning is happening in the setting of active alcohol or drug use, extra structure and monitoring can make a big difference. Learn about support options at Wimberley inpatient rehab.
Questions to ask your doctor
- “What are the risks of relapse if I lower my dose or stop?”
- “If I stay on Lexapro, what newborn signs should we watch for after delivery?”
- “What is the plan if my symptoms get worse during pregnancy?”
If you’re trying to conceive on Lexapro: a safer plan
If you are stable on Lexapro and want to start a family, the safest next step is a shared plan. That usually means your prescribing doctor and prenatal doctor agree on the same approach.
Steps that help most people
- Say the goal out loud: “We want to try to get pregnant.” That changes the risk–benefit talk.
- Ask about timing: if a dose change is needed, many doctors prefer doing it before pregnancy, not during a crisis.
- Build non-drug supports: therapy, sleep routines, movement, and social support reduce relapse risk.
- Review all substances honestly. Alcohol, nicotine, cannabis, and non-prescribed pills can affect sperm, ovulation, and early pregnancy.
- Keep the basics simple: regular meals, steady sleep, and a plan for stress make medication decisions easier.
If you need a structured setting to address substance use and mental health at the same time, intensive care can provide medical oversight and daily support. Learn more about Austin residential inpatient rehab.
Many people can stay on Lexapro, adjust it, or switch it and still reach their family goals. The safest path is one that protects your mental health while you plan for pregnancy.
