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Study breakdown

How cannabis and cannabinoids affect reproductive hormones and fertility

ReviewModerate evidence
The takeaway

THC disrupts the hypothalamic-pituitary-gonadal axis, affecting key reproductive hormones, folliculogenesis, ovulation, and sperm function, though most evidence comes from preclinical studies.

People trying to conceive, fertility specialists, and reproductive health researchers.

THC disrupts GnRH, affecting folliculogenesis, ovulation, and sperm function

What the researchers found

THC indirectly decreases GnRH secretion from the hypothalamus, leading to disruptions in multiple reproductive hormones. This affects folliculogenesis, ovulation, and sperm maturation and function. While generally accepted that cannabinoid consumption impacts fertility, most strong evidence comes from preclinical rather than human studies.

Why it matters

Cannabis use is highest among young adults of reproductive age. Understanding its effects on fertility is important for those planning families.

The numbers in context

THC affects GnRH, folliculogenesis, ovulation, and sperm function. Cannabinoid receptors are present throughout the reproductive system.

How the study worked

Narrative review of clinical and preclinical evidence on cannabis effects on the endocannabinoid system in reproduction, the hypothalamic-pituitary-gonadal axis, male and female fertility, and teratogenicity.

What this study cannot tell us

Strong evidence mostly from animal studies. Human clinical data on fertility outcomes is limited and often confounded by other factors. Dose-response relationships in humans are poorly characterized.

How to read the evidence

Narrative review with strong preclinical evidence but limited human clinical data on fertility outcomes.

When this study was published

Published in 2022.

The bigger picture

The endocannabinoid system plays a natural role in reproduction, and external cannabinoids from cannabis use disrupt this finely tuned system at multiple points.

Questions still open

  • At what frequency and dose does cannabis meaningfully impair fertility? Are effects reversible after stopping cannabis use?

Common questions

Does cannabis affect male and female fertility equally?
Both are affected but through different mechanisms. THC disrupts folliculogenesis and ovulation in females and sperm maturation and function in males, all stemming from disrupted hormone signaling through the hypothalamic-pituitary-gonadal axis.
Is most of the evidence from humans?
No. While the general impact of cannabinoids on fertility is accepted, most strong evidence comes from preclinical (animal and cell) studies. Human data is limited and often complicated by confounding factors.

Read the original research

Cannabis and Cannabinoids in Reproduction and Fertility: Where We Stand.

Reproductive sciences (Thousand Oaks, Calif.), 29(9), 2429-2439

Citation

Fonseca, Bruno M; Rebelo, Irene. (2022). Cannabis and Cannabinoids in Reproduction and Fertility: Where We Stand.. Reproductive sciences (Thousand Oaks, Calif.), 29(9), 2429-2439. https://doi.org/10.1007/s43032-021-00588-1

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