The Effect of Marijuana on the Incidence and Evolution of Male Infertility: A Systematic Review

Abstract

Over the past decade, the consumption of marijuana or any other form of cannabis, whether medically, recreationally, or illegally, has been escalating worldwide. The additive effect of marijuana and the easy availability could make this increasing trend possible for imperceptible outcomes affecting one's physiology on multiple levels. The rationale of this review is to study and enumerate several effects marijuana may have on male reproductive organs, especially in men who are dealing with subfertility or infertility issues. A literature search was done from September 1, 2021, to September 14, 2021, using the following databases: PubMed, Google Scholar, Bielefeld Academic Search Engine (BASE), University of California, Santa Barbara Library, and PubMed Central. The studies included in this review comprised systematic reviews, cross-sectional, case-control, cohort, and longitudinal studies published during 2010-2021 in the English language. After an extensive review of all studies, the quality was assessed using appropriate quality appraisal tools, and 15 eligible reports were identified and included. In-depth research on the final studies concluded that marijuana seems to have specific adverse effects on the sperm parameters, namely, sperm count, concentration, motility, morphology, capacitation, and viability, thus affecting fertility in men. Certain hormone levels, including testosterone, luteinizing hormone, and follicle-stimulating hormone, also drew attention, potentially impacting men's fertility; however, a finite inference could not be substantiated by the studies. Although the studies show significant effects in sperm parameters and organic sexual dysfunction, it is also to be noted that these studies are observational only and are conducted in small groups in multicenter geographical locations where other lifestyle patterns could be confounding. Given this restriction, it is suggested that further human trials on a larger scale be conducted to provide an even more concrete conclusion, especially after considering other factors that may affect the generalization of these trials.

THC and sperm: Impact on fertilization capability, pre-implantation in vitro development and epigenetic modifications

“…THC doses used in the present study reflect plasma concentrations following therapeutic (0.032μM) and low (0.32μM) to high (4.8μM) recreational cannabis use [ 20 , 100 ], as per Whan et al, (2006). Plasma concentrations of THC are moderately correlated with seminal levels, ranging from 0.87–0.97ng/mL in the semen of chronic cannabis users 10–12 hours after cannabis exposure [ 101 ].…”

“…The lack of clear medical guidelines regarding cannabis use and male fertility is largely a result of inconclusive research. Some studies report a harmful effect of cannabis on sperm counts, morphology, motility, capacitation and the acrosomal reaction (AR) [16][17][18][19][20][21][22], while others have associated cannabis use with protection against abnormal sperm motility [16] and higher sperm counts [23]. Despite the harmful impact of cannabis on sperm [21], there is very limited research investigating the effects of paternal cannabis use on more clinically relevant outcomes, such as embryo quality following IVF [24,25].…”

Deteriorating Semen Quality: The Role of the Environment

“…79 Experimental studies and epidemiological human studies have indicated that marijuana use is associated with reduced sperm concentration, total sperm count, sperm morphology, and motility. [80][81][82] However, in a metaanalysis of human studies, cannabis use was not associated with a significantly increased risk of having any abnormal semen variable. Only four studies were included in the metaanalysis and there was considerable heterogeneity between the studies.…”

Cannabis Use and Its Multifaceted Impact on the Genitourinary System: A Scoping Review of the Literature

“…In males, studies have reported cannabis-associated changes in sperm morphology, reduced sperm count, and altered hormone levels, potentially contributing to fertility issues. 14 Females, on the other hand, may experience irregular menstrual cycles, potential impact on fertility, and possible effects on urinary symptoms related to cannabis use. 15 The GU system plays a vital role in our overall health and wellbeing.…”