How Marijuana Can Affect Fertility
Elizabeth Hartney, BSc, MSc, MA, PhD is a psychologist, professor, and Director of the Centre for Health Leadership and Research at Royal Roads University, Canada.
Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more.
Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital.
Although the link between marijuana and fertility is not straightforward—plenty of marijuana smokers get pregnant and get their partners pregnant—some research has demonstrated that marijuana use can negatively impact you, your partner, or the fertility of both of you.
Research suggests that marijuana can negatively affect female fertility in the following ways:
- Decreases libido. Even before intercourse takes place, marijuana use may decreases libido. And if you aren’t feeling in the mood, it’s that much more difficult to get started.
- Increases the risk of miscarriage. Marijuana use also increases the risk of miscarriage. Marijuana is known to cross the placenta and may pose a risk to the fetus, although the effects of marijuana exposure in the womb are not as well documented as the effects of alcohol and some other drugs.
Furthermore, the effects of marijuana on fertility seem to accumulate over time. This means that although teenage girls who smoke marijuana are more likely to get pregnant, by the time a chronic marijuana smoking woman is in her mid-twenties, she may be more likely to experience a delay in getting pregnant.
Despite the relaxation effects that many people associate with marijuana use, research has shown marijuana has negative effects on the male sexual response.
- Increases impotence. Cannabis use has been associated with sexual dysfunction, which can also have negative effects on the male ego. If your partner has been impotent, he may be feeling more pressure to have sex to get you pregnant, but be frustrated with his inability to do so. This can lead to misunderstandings between you that make it more difficult to have sex.
- May lead to premature ejaculation. Marijuana use has been associated with premature ejaculation.
- May decrease sperm count. A regular smoker of marijuana has a risk of having a lower sperm count.
- Affects sperm structure and function. Additionally, the sperm produced by marijuana smoking has been associated with abnormal morphology (shape) and motility (its ability to “swim” and fertilize the egg).
Quit to Prepare for Parenthood
Obviously, if you are both smoking marijuana, you risk increasing the chances of infertility as a couple.
Quitting marijuana can be harder than many long-term marijuana users expect, so you and your partner would be wise to quit as soon as possible, while you still have time to get help before getting pregnant. If either or both parents still use marijuana when the baby arrives, you are increasing the risk that your child may use drugs in the future, and parental drug use is implicated in many difficulties for children and families.
Your family doctor can help you with a referral to a counselor or clinic that can help you both quit. Couples counseling, which is offered by many addiction clinics, would be particularly helpful at this time. If you are already engaged in infertility treatment, coming clean about your marijuana could save you a lot of time, money, and heartache, if marijuana is one of the culprits for your difficulties with conception.
Three Ways Marijuana Can Affect Fertility
Some studies show that marijuana use negatively affects fertility in men and women. Many articles and physicians advise against using marijuana while trying to get pregnant to reduce the risks of infertility. Learn more about the warnings signs of infertility and discover how you can develop healthy habits to increase your chances of getting pregnant.
Anna Klepchukova, MD
1. Ovulation delay
Scientists aren’t sure exactly how THC affects the sexual function of women attempting to get pregnant. THC affects the hypothalamic-pituitary-gonadal (HPG) axis, which controls how your sex hormones interact. Continuous exposure to THC can inhibit the secretion of luteinizing hormone and prolactin from the pituitary gland in males and females. These hormones influence your chances of getting pregnant.
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In women, high THC doses interfere with the menstrual cycle and may delay or prevent ovulation. Cannabinoids inhibit the activity of the HPG axis, meaning that marijuana use decreases the production of several hormones and can inhibit sexual behavior — if your sex drive is down, this can also hinder your efforts to conceive.
Regular smokers may have an elevated risk of not ovulating at all. A 2016 report also suggests marijuana disrupts the menstrual cycle and can lead to anovulatory cycles (cycles without ovulation).
In general, it’s thought that marijuana can affect the production of luteinizing hormone in women. LH regulates testosterone production in men and stimulates female ovulation. When men smoke frequently, they tend to have lower levels of testosterone, and women who smoke frequently have less LH.
In addition to marijuana use, it’s important to examine other causes of late ovulation so you can put yourself in the best position for a successful pregnancy.
2. Lower sperm count
According to the Mayo Clinic, marijuana use can impair a man’s sperm count and ability to reproduce. Other research has suggested that marijuana is bad for men’s fertility.
However, a Harvard study surprisingly refutes those findings and states that there’s no evidence of harmful effects on fertility. In the study, researchers collected blood samples and semen from hundreds of volunteers at the Massachusetts General Hospital fertility clinic. In the study, which ran from 2000 to 2017, men were asked about their marijuana use. The results showed no correlation between marijuana use and male fertility.
Since there isn’t a conclusive determination on the subject, if you have a male partner who smokes, try to discourage him from doing so while you are trying to conceive — especially if his sperm count is low.
3. Deterioration of existing fertility problems
There’s no conclusive evidence that marijuana use causes infertility, but research has found that it can lower sperm count, increase anovulatory cycles, and disrupt the balance of hormones in the body that encourage pregnancy.
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Effects of Cannabis on the Male and Female Reproductive System, and Fertility
Use of cannabis may affect human fertility, depending on gender, general health, socioeconomic status and several other factors. Here, we look at existing research on cannabis and human fertility, in order to provide readers with an accurate, up-to-date summary of the current state of scientific knowledge.
To understand how cannabis may affect fertility, we must understand the effect it has specifically on males and on females. We’ll start by looking at the effects on the male reproductive system, and then focus on the more complicated effects on female fertility.
Cannabis use and male fertility
Some studies on the effect of cannabis use on male fertility have indicated that regular use may reduce spermatogenesis (the production of sperm in the testes) and testosterone levels.
In 2012, the American Society of Andrology published a review of research on the effects of illicit drug use on male fertility. The researchers found that in the majority of studies, it was consistently concluded that cannabis use had a negative impact on male reproductive physiology.
Another study in 1992 (Vescovi et al.) found that levels of luteinizing hormone(LH), an important pituitary gland hormone involved in reproductive function, were reduced in male chronic cannabis users compared to a non-cannabis-using, age-matched control group. A previous 1986 study (Cone et al.) also found a significant reduction in LH levels immediately after smoking cannabis.
And an even earlier study (Kolodny et al, 1974) into testosterone levels in “chronic” cannabis users found that 6 of 17 subjects had oligospermia (low sperm count), and that average testosterone levels in the cannabis-using group were just over half that of the control group. The effect of cannabis on testosterone levels was observed to be dose-dependent.
Sexing Cannabis: Is My Plant Male or Female?
The endocannabinoid system and male fertility
Clearly, the endocannabinoid system has a role to play in the regulation of processes critical to male reproductive health, such as sperm count, testosterone levels, and levels of other key hormones such as LH.
For healthy adult males, it seems that use of THC does indeed cause some negative effects on fertility, which tend to increase with higher doses. However, THC’s endogenous analogue anandamide appears to be critical to the functioning of the male reproductive system.
The 2002 study found that sperm cells would bind to the agonist CP-55,940, demonstrating the presence of CB1-receptors. The study also concluded that the presence of THC and a synthetic anandamide analogue, AM-356, both reduced sperm motility in vitro. Interestingly, it was found that AM-356 exerted a biphasic dose-dependent effect on sperm motility, causing inhibition at high doses but hyperactivity at low doses.
Anandamide and the “capacitation” of human sperm cells
In a 1994 study, it was found that mammalian sperm, including that of humans, is actually incapable of fertilizing oocytes (eggs) immediately after leaving the testes. It requires a period of exposure to certain crucial hormones, enzymes and proteins on its journey through the vas deferens and ejaculatory ducts of the male reproductive system (as well as the reproductive fluids of the female vagina and oviducts) before becoming “capacitated” and able to fertilize an egg.
The 2002 study provides strong evidence that the presence of the anandamide in the seminal fluid, and its ability to bind to the CB1-receptors of the spermatozoa, are key to the “capacitation” of sperm cells on their way to the ejaculatory ducts. It has to be present in the appropriate concentrations, though. If the level of anandamide is too high, it can instead have a dramatic inhibitory effect on the sperm cells’ ability to fertilize oocytes.
How Does Cannabis Affect the Digestive System?
Why is anandamide beneficial, while THC may not be?
Although THC and anandamide are both agonists of the CB1-receptors, they greatly differ in structure and therefore have different effects on certain metabolic processes. Anandamide has a much shorter half-life than THC (just a few minutes for anandamide compared to as long as 24 hours for THC). So while anandamide will degrade shortly after it contacts a receptor, THC can remain in nearby adipose tissue for much longer periods, and can continue to stimulate the receptors, ultimately causing overstimulation and potential negative effects.
As is so often the case with cannabinoid science, dosage is everything—and it may prove to be the case that very small doses of THC could benefit males who have reproductive issues that can be tied to low levels of anandamide.
Cannabis use and female fertility
While the effect of cannabis use on male fertility appears to be quite straightforward—with male chronic cannabis users being likely to experience some degree of impairment to reproductive physiology—the effect on the human female reproductive system is less clear-cut.
Female reproductive health is vastly complex in itself, as it not only comprises the ability to become pregnant but also the ability to carry healthy offspring to term and successfully give birth.
Past research has indicated that cannabis use may disrupt the menstrual cycle, suppress oogenesis (production of eggs in the ovaries) and impair embryo implantation and development. Chronic use of cannabis has also been repeatedly associated with lower birth weight (as much as a 50% increased risk), decreased birth weight and early (spontaneous) termination of pregnancy.
However, most of these findings are far from conclusive. Either the study included very few participants or confounding factors such as tobacco use aren’t taken into consideration. In fact, more recent research, like this review on infants who were exposed to marijuana in-utero, concludes there aren’t any adverse risks.
For example, a 1985 paper on foetal abnormality (Qazi et al.) after prenatal exposure to cannabis discussed five infants whose mothers acknowledged use of cannabis prior to and during pregnancy and who were born with various symptoms of growth retardation, neurological dysfunction and deformity. While it may provide helpful insight, such a small sample size is far from being enough to draw concrete conclusions, and correlation does not imply causation.
Other studies seen as providing evidence that cannabis use can cause foetal abnormalities are animal studies (Geber & Schramm 1969, Phillipset al, 1971) in which rabbits, hamsters, rats and mice were injected with vast doses of crude cannabis extract (as much as 666mg/kg in one instance!). Such massive doses of cannabis would be practically impossible for a human to consume through conventional means, and are essentially useless as a point of comparison.
In fact, many early studies that indicated a correlation between use of cannabis (or other controlled substances such as cocaine) have been later contradicted by findings suggesting that socioeconomic status and level of poverty are far more causative of low birth weight and poor developmental outcome than use of the substances themselves. This doesn’t imply that use of cannabis or other substances during pregnancy has no adverse effect, but does give weight to the idea that the risks have been overestimated and overemphasized due to politics and anti-drug bias.