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Cited by 29Sperm and Testicular FunctionCannabis and Cannabinoid ResearchPrenatal Substance Exposure Effects

Evaluation of the impact of marijuana use on semen quality: a prospective analysis

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Hehemann, Marah C., Raheem, Omer A., Rajanahally, Saneal, Holt, Sarah, Chen, Tony, Fustok, Judy N., Song, Kelly, Rylander, Heather +4 more·2021·Therapeutic Advances in Urology
DOI 10.1177/17562872211032484PMC PMC8299873
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Abstract

Aims: To assess if marijuana consumption – prevalent among men of reproductive age and becoming widespread due to decriminalization – is associated with changes in semen parameters. Marijuana’s active metabolite, tetrahydrocannabinol, can alter signaling pathways within spermatozoa, affecting spermatogenesis and fertility. Methods: We prospectively evaluated semen analyses (SA) from men presenting for infertility evaluation at one institution from July 2017 to April 2018. Participants completed a reproductive health questionnaire including items regarding marijuana consumption. SA was performed in accordance with World Health Organization (WHO) 5th Edition criteria. SA parameters included volume (ml), concentration (million/ml), motility (%), progressive motility (%), and Tygerberg strict morphology (%). Results: A total of 409 patients completed the questionnaire; 174 (43%) men reported marijuana use (ever-users). Current and past users comprised 71 (17%) and 103 (25%), respectively. Compared with never-users, current and past users had a significantly higher likelihood of abnormal sperm strict morphology (33.1% versus 50.7% and 53.4%, respectively; p < 0.001). However, sperm motility was more likely to be less than WHO reference values in never-users than current and past-users (38.3% versus 21.1% and 27.2%, respectively; p = 0.01). In multivariate logistic regression analyses, current use was associated with increased odds of abnormal strict morphology [odds ratio (OR) 2.15, 95% confidence interval (CI): 1.21–3.79] and semen volume less than WHO reference value (OR 2.76, 95%CI: 1.19–6.42), while odds of less than WHO reference value sperm motility were reduced (OR 0.47, 95%CI: 0.25–0.91). Conclusion: Marijuana use is common among men presenting for fertility evaluation, and may have a detrimental effect on semen quality, particularly morphology and volume, but may be protective against abnormal sperm motility. Large, prospective studies of both semen quality and fertility in this growing, at-risk population are warranted.

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  • A survey of 409 infertile men found that the use of marijuana resulted in abnormal sperm parameters, especially semen volume and sperm morphology.

    “Another survey of 409 infertile men found that the use of marijuana resulted in abnormal sperm parameters, especially semen volume and sperm morphology (59).”

    From Isolated teratozoospermia: revisiting its relevance in male infertility: a narrative review (2024) · cites this paper as [59]

    The Discussion reports a prospective cross-sectional study of 409 men presenting for fertility evaluation and greater odds of abnormal strict morphology and semen volume among marijuana users. The claim overstates this association as a causal result and calls all 409 men infertile, whereas the paper describes them as presenting for fertility evaluation. (LLM, conf=0.87)

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Authors
Hehemann, M. C., Raheem, O. A., Rajanahally, S., Holt, S., Chen, T., Fustok, J. N., Song, K., Rylander, H., Chow, E., Ostrowski, K. A., Muller, C. H., & Walsh, T. J.
Affiliations
  • University of Washington (US)
  • Tulane University (US)
  • Baylor College of Medicine (US)
  • EvergreenHealth (US)
Corresponding author
Raheem, Omer A.
ORCID
Venue
Therapeutic Advances in Urology
Publisher
SAGE Publications
Published
2021-01
Volume
13
Pages
17562872211032484-17562872211032484
ISSN
  • 1756-2872 (ISSN-L)
  • 1756-2880
DOI
10.1177/17562872211032484
PMC
PMC8299873
OpenAlex
W3186437870
Cited by
29
References
2
Citations by year
2026: 1 · 2025: 10 · 2024: 11 · 2023: 5 · 2022: 1 · 2021: 1
FWCI
3.87
Type
journal article
Language
en
Open access
Licence
Locations
  • Therapeutic Advances in Urology (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Health Sciences › Medicine › Reproductive Medicine › Sperm and Testicular Function
  • Health Sciences › Medicine › Pharmacology › Cannabis and Cannabinoid Research
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Prenatal Substance Exposure Effects
Keywords
cannabis use, tetrahydrocannabinol, semen quality, male infertility, sperm morphology, sperm motility, semen volume, spermatogenesis, cannabis decriminalization, reproductive health

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