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Sertraline was shown to impair both the ligand-induced acrosome reaction and spermatozoa entry into viscous media and it almost completely inhibited the sperm-specific Ca 2+ -permeable ion channel (CatSper), with a significant inhibitory effect on prostaglandin-induced Ca 2+ influx (Figure 1)

A lag time of 6 months before cancer diagnosis was used to reduce the risk of reverse causation

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Notably, the authors highlighted significant methodological limitations across the included studies, such as small sample sizes, short follow-up durations, and high heterogeneity in baseline selenium status, dosage regimens, and patient populations

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