Cannabis and Male Fertility: A Systematic Review.

With cannabis consumption on the rise, and use prominent among males of reproductive age, it is essential to understand the potential impact of cannabis on male fertility. Here we review the literature regarding cannabis' effects on male fertility.A literature search was conducted using PubMed/MEDLINE to identify relevant studies examining the effects of cannabis on male fertility. Relevant studies were identified and reviewed.The strongest evidence for cannabis-induced alterations in male fertility is in the category of semen parameters. Research supports a role for cannabis in reducing sperm count and concentration, inducing abnormalities in sperm morphology, reducing sperm motility and viability, and inhibiting capacitation and fertilizing capacity. Animal models demonstrate a role for cannabis in testicular atrophy and reduced libido and sexual function, but these results have not yet been replicated in human studies. Studies examining hormonal changes suggest inconclusive effects on testosterone levels, lowered luteinizing hormone (LH) levels, and unchanged follicle stimulating hormone (FSH) levels.Current research suggests that cannabis may negatively impact male fertility. Further studies are needed to validate that robust findings in animal models will carry over into human experience. Clinicians should be aware of these potential effects in prescribing medical marijuana therapies to men of reproductive age, and should consider degree of cannabis use as a possible component of a complete male infertility workup.