Exploring the Association Between Cannabis Use and Male Reproductive Parameters: A Systematic Review and Meta-Analysis.
Nilson Marquardt, Otto Rauber Felkl, Davi Marçola Veiga et al.
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In 30 seconds
This systematic review and meta-analysis examined associations between cannabis use and male reproductive parameters. It included 18 studies reporting sperm outcomes (5,766 patients; 6,231 samples) and hormonal outcomes in 21,066 patients. Cannabis users had lower sperm morphology than non-users (MD = -1.02; 95% CI: -1.93 to -0.10; p < 0.05), including in analyses restricted to studies following WHO criteria. No significant differences were found in several other sperm measures or in testosterone, FSH, and LH; SHBG was higher among users (MD = 3.90; 95% CI: 1.67-6.13; p <0.05).
Key findings
- Sperm morphology was lower in cannabis users than non-users (MD = -1.02; 95% CI: -1.93 to -0.10; p < 0.05).
- No significant differences were found in sperm concentration, ejaculate volume, total sperm count, or progressive and total motility.
- Testosterone, FSH, and LH did not differ; SHBG was higher in cannabis users (MD = 3.90; 95% CI: 1.67-6.13; p <0.05).
Why it matters
The findings identify sperm morphology as a reproductive parameter associated with cannabis use, while suggesting that other measured semen and hormone outcomes may not differ. This may help frame lifestyle assessment in men undergoing evaluation for subfertility or infertility. Because the evidence is associative and does not establish causality, the results do not show that cannabis use causes impaired fertility.
What to keep in mind
The included evidence could not establish causality. The abstract also notes that further studies of sperm function are needed to clarify effects on testicular function and fertilizing capacity.