Infertility and THC Use By Mike Dougherty on September 12, 2023

It has long been theorized that tetrahydrocannabinol (THC) use, the main psychoactive component in marijuana, is associated with infertility and sub fertility.  However, well designed studies with appropriate controls have been lacking.  There is now sufficient data to say that chronic THC use impacts fertility likely through end organ damage to test testicle and ovary although the specific mechanism is still unclear.

Male non-human primate studies have identified a decrease in testicular volume, and associated increase in follicle stimulating hormone (FSH) and lower sex hormone serum levels suggesting testicular end-organ impacts.  Additionally, other studies have identified poor DNA integrity assessed by sperm DNA fragmentation assessment.  This indicates that even if sufficient sperm is present chronic THC use likely impacts DNA integrity is a dose dependant manner.  Similar results were seen in female non-human primates showing increased FSH levels as well as increased cycle length with chronic THC use.

Recent findings suggest that even with chronic THC use, cessation can allow for at least a partial return of function and improved sperm integrity.  Further studies are needed to evaluate the epigenome alterations.  The epigenome plays an important role in gene expression.  Currently, there appear to be significant alterations in the sperm epigenome with chronic THC use.  Initial studies have shown return of epigenome patterns with cessation of THC use as well as a partial return in testicular function.  This supports the notion that even with an extensive history of THC use, outcomes can be improved with cessation.  

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Dr. Louis R. Manara

Center for Reproductive Medicine and Fertility

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