A review of 64 studies found cannabis disrupts male fertility (sperm quality, testosterone), female reproduction (ovulation, placental function), and fetal development (birth weight, preterm risk)—affecting the entire reproductive process.
Couples planning families who use cannabis, reproductive endocrinologists, obstetricians, and andrologists.
What the researchers found
This review maps how cannabinoids interact with the reproductive system from conception through birth, covering territory that's usually examined in separate studies.
For men: cannabinoids interfere with spermatogenesis, reduce sperm motility and quality, and lower testosterone levels. These effects have been demonstrated in both clinical and experimental studies. For couples trying to conceive, this means cannabis use by either partner could affect fertility.
For women: cannabinoid-induced disruptions include negative effects on ovarian follicle maturation, ovulation, and placental function. The placental effects are particularly concerning because the placenta is the fetus's lifeline—disrupting its function can affect nutrient and oxygen delivery.
For fetal development: prenatal cannabis exposure is associated with reduced birth weight, preterm delivery, and developmental effects that can extend into childhood. These findings align with RTHC-00209's review specifically on neonatal outcomes.
The review emphasizes that the endocannabinoid system plays critical regulatory roles at every stage of reproduction—from sperm development through embryo implantation through placental formation through fetal brain development. Introducing exogenous cannabinoids disrupts a system that needs to function precisely during these processes.
Why it matters
Most reproductive cannabis research focuses on either male fertility, pregnancy outcomes, or fetal development in isolation. This review connects the entire reproductive arc, showing that cannabis doesn't just affect one stage—it can disrupt the process at every point from conception through delivery. For couples planning families, this comprehensive picture is more informative than any single study.
The numbers in context
64 studies reviewed. Male effects: reduced spermatogenesis, sperm motility, sperm quality, and testosterone. Female effects: disrupted follicle maturation, ovulation, and placental function. Fetal effects: reduced birth weight, increased preterm risk, developmental impacts.
How the study worked
Non-systematic narrative review. Searched PubMed, Scopus, Web of Science, and Google Scholar in November 2024. After screening, 64 studies included covering cannabis effects on male fertility, female reproductive system, placental function, and prenatal/postnatal outcomes.
Who was studied
64 studies reviewed, focusing on reproductive health and prenatal development.
What this study cannot tell us
Narrative review with non-systematic search—may miss relevant studies. The 64 included studies vary widely in quality, methodology, and populations. Much of the evidence on fertility effects comes from animal studies or in vitro work. Human reproductive studies are confounded by polysubstance use, socioeconomic factors, and self-reported cannabis use. The review covers a very broad scope, limiting depth on any single topic.
How to read the evidence
Narrative review of 64 studies—comprehensive in scope but limited by non-systematic methodology and the predominantly observational evidence base.
When this study was published
Published in 2025 with literature searched through November 2024.
The bigger picture
This comprehensive view connects to the more focused studies: RTHC-00209 (neonatal outcomes specifically), RTHC-00191 (timing of prenatal exposure and amygdala effects), RTHC-00217 (cannabinoid effects on GABA neurodevelopment), and RTHC-00151 (reduced neonatal brain volume). The male fertility dimension adds an often-overlooked angle—while most pregnancy-cannabis research focuses on maternal use, paternal cannabis use may also affect conception.
Replication
Not stated in abstract.
Funding
Not reported in abstract.
Conflicts of interest
Not reported in abstract.
Questions still open
- How long before conception should men and women stop cannabis to avoid reproductive effects? Are fertility effects reversible with cessation? Does the rising potency of cannabis products mean greater reproductive risk than what earlier studies captured?
Read the original research
Effects of Phytocannabinoids on Reproductive System and Prenatal Development: Mechanisms and Clinical Implications.
Journal of clinical medicine, 14(18)
The Journal of Clinical Medicine is a peer-reviewed journal known for publishing high-quality clinical research.
Citation
Wesołowski, Michał; Sobaś, Aleksandra; Biedka, Kamil; Karwacki, Jakub; Bulski, Jakub; Błaszczyk, Katarzyna; Żełabowski, Kacper; Ziobro, Oliwia; Maj, Filip Jacek; Sornat, Karol; Estreicher, Agata; Klasa, Anna; Dłubak, Andrzej; Sebzda, Tadeusz. (2025). Effects of Phytocannabinoids on Reproductive System and Prenatal Development: Mechanisms and Clinical Implications.. Journal of clinical medicine, 14(18). https://doi.org/10.3390/jcm14186494
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