Former cannabis users had higher odds of infertility than never-users, but current users did not | Research

The takeaway

NHANES data showed former cannabis users aged 18-35 had more than double the odds of infertility compared to never-users, particularly those who quit over 3 years ago, while current users showed no elevated risk.

Reproductive health researchers, fertility specialists, women considering cannabis use

Former users abstinent 3+ years had 2.94x higher odds of infertility than never-users

What the researchers found

Former cannabis users had 2.04x odds of infertility vs never-users; current users showed no significant difference; among former users 18-35, those abstinent 3+ years had 2.94x odds; shorter abstinence showed no significant difference.

Why it matters

The counterintuitive finding that former (not current) users show elevated infertility risk suggests possible delayed reproductive effects or confounding factors that warrant further investigation.

The numbers in context

1,694 women; former users OR 2.04 (95% CI: 1.21-3.43); ages 18-35 former users OR 2.37 (95% CI: 1.11-5.04); 3+ years abstinence OR 2.94 (95% CI: 1.29-6.71); current users: no significant association.

How the study worked

Cross-sectional analysis of NHANES 2013-2018; 1,694 female participants aged 18-45; logistic regression adjusting for covariates; subgroup analyses by age and abstinence duration.

What this study cannot tell us

Cross-sectional design cannot establish causation; former users may have quit due to fertility-related health advice (reverse causation); self-reported cannabis use and infertility; cannot control for all confounders.

How to read the evidence

Nationally representative dataset with adequate sample size and adjusted analyses, but cross-sectional design makes the unexpected pattern difficult to interpret causally.

When this study was published

Published 2025, NHANES 2013-2018 data

The bigger picture

This unusual pattern where former but not current users show higher infertility risk raises important questions about whether past cannabis use has lasting reproductive effects or whether the finding reflects other factors like why people stopped using.

Questions still open

Did former users quit because they were trying to conceive and already had difficulty? Could past cannabis use cause lasting reproductive changes? Would prospective studies replicate this pattern?

Common questions

Does cannabis use cause infertility?

The study found former cannabis users had higher odds of infertility, but current users did not. This pattern makes it difficult to conclude direct causation, as reverse causation (quitting due to fertility problems) is possible.

Why would former users have higher risk than current users?

Possible explanations include delayed reproductive effects, or that some women quit cannabis specifically because they were struggling to conceive, creating the appearance of an association.

Read the original research

Association of cannabis use with female infertility based on NHANES.

Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology, 45(1), 2502663

View on PubMed ↗Publisher’s paper ↗

Citation

Chen, Chao; Wu, Yang; Pei, Lipeng; Ren, Wei. (2025). Association of cannabis use with female infertility based on NHANES.. Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology, 45(1), 2502663. https://doi.org/10.1080/01443615.2025.2502663