As if the number of fertility-issue-causing concerns wasn’t long enough, recent (2021) research¹ has shown that regular consumption of THC, the psychoactive compound of marijuana, is potentially harmful to male fertility. The study showed that in current and past human users, marijuana had a significantly higher risk of abnormal sperm morphology versus non-users. Semen volume was also lower in current and past users.
Another study² conducted on non-human subjects (rhesus macaque monkeys), giving them daily THC, showed the testes of the animal subjects reduced in size and increased fragmentation of DNA. These associations were directly correlated to increased use.
On the bright side, the non-human study showed that after withdrawing from the use of THC, some of the subject’s function was restored, so there is reason to believe that abstinence from THC can mitigate some of its damaging effects. Whether these functions can be fully restored will remain a question to be answered by future studies.
Why This Data Is Important
Cannabis and, by extension, THC use is being legalized across the United States, and what was once an illicit drug is now readily available. Recent 2021 past-year trends in marijuana show that approximately 43% of young adults consume THC³, which potentially has significant implications for future fertility rates.
It’s also instructive to us as urologists in helping us understand and ultimately diagnose our patient’s fertility issues. If, for example, a couple comes to the office unable to conceive, and a medical history shows that the male patient has a history of cannabis use, we can direct our care appropriately.
The Longer-Term Implications
Unfortunately, this is a situation in which we have very little control. Naturally, adolescents and many young adults are not thinking about future family planning and may not be as concerned about their fertility as they should be. Further, the draw of hallucinogenic drugs like marijuana may be strong enough that many younger patients are willing to take the fertility risk to enjoy the high. Ultimately, as with any other health concern, information is critical. Educating our patients to make the best risk-reward decision for them is part of our jobs, and Dr. Kapadia is available for consultation with couples having difficulty conceiving due to male fertility issues.
References:
- Hehemann MC, Raheem OA, Rajanahally S, et al. Evaluation of the impact of marijuana use on semen quality: a prospective analysis. Therapeutic Advances in Urology. 2021;13. doi:10.1177/17562872211032484
- Hedges JC, Hanna CB, Shorey-Kendrick LE, Boniface ER, Bash JC, Rice-Stitt TL, Burch FC, D’Mello R, Morgan TK, Lima AC, Terrobias JJD, Graham JA, Mishler EC, Jensen JV, Hagen OL, Urian JW, Spindel ER, Easley CA 4th, Murphy SK, Lo JO. Cessation of chronic delta-9-tetrahydrocannabinol use partially reverses impacts on male fertility and the sperm epigenome in rhesus macaques. Fertil Steril. 2023 Mar 24:S0015-0282(23)00167-X. doi: 10.1016/j.fertnstert.2023.02.034. Epub ahead of print. PMID: 36990913.
- NIDA. 2022, August 22. Marijuana and hallucinogen use among young adults reached all time-high in 2021. Retrieved from https://nida.nih.gov/news-events/news-releases/2022/08/marijuana-and-hallucinogen-use-among-young-adults-reached-all-time-high-in-2021 on 2023, May 16