By Dr. Lisa Becht

The legalization of marijuana in California and several other states has been helping to shine a spotlight on the impact of this drug on the male and female reproductive systems.

Men and women are smoking cannabis as well as consuming edibles for both recreational and medicinal purposes. But those trying to conceive need a better understanding of how using marijuana, legally or illegally, can impact their fertility just as they should be aware of alcohol’s effects. The jury, however, still is out on the extent and specifics of marijuana’s influence on people trying to have a baby.

Prospective parents and infertility specialists face several obstacles when they comb the research about marijuana. First, there is a shortage of studies that have focused on this subject. Hopefully, this will change as cannabis usage becomes more widespread and mainstream. A second challenge is discerning whether the current research is accurate and conclusive. Doctors need up-to-date information to counsel their patients with proper advice. The results of various investigations to-date either have been contradictory, were not able to adequately measure the drug’s effects or quantify the amount of marijuana consumed or were based on the respondents’ subjective recall of their usage versus objective data.

However, a current analysis of the analyses on marijuana’s impact reveals several possible reproductive consequences: decreasing sperm count and quality, lower sexual libido and potential impotence, and ovulation problems. Interestingly, a recent study in the Canadian Medical Association Journal found marijuana did not cause these problems, but, rather, exacerbated already existing fertility issues.

THC and the reproductive system

THC, delta-9-tetrahydrocannabinol, is the main ingredient in marijuana that gives users the feeling of being ‘high’ or relaxed. THC is a cannabinoid, though not one produced in your body. Those cannabinoids bind with receptors in the endocannabinoid system, which controls functions such as reproduction, pleasure, hunger, and sleep.

THC replaces the body’s natural cannabinoid receptors, affecting sperm with a reduced count and changes in its size, motility, and speed and also causes ovulation issues for intended moms.

Sperm parameters

An exploration of the marijuana habits of over 1200 young Danish men, published In 2015 in the American Journal of Epidemiology, showed that regular cannabis smoking of more than once per week reduced sperm concentration by 52% and total sperm count by 55%, though it was unclear if the young men studied also used other recreational drugs. These types of sperm changes generally are not seen until men reach middle age, which concerned the investigators. Another recent study also found men undergoing fertility workup who used marijuana had decreased sperm motility and morphology.

However, research conducted by Boston University found there was no link between pot use and the likelihood of conceiving, though the male partner’s sperm was not analyzed for this project. It is reassuring news if a man needs to use marijuana for medical purposes.

Libido decrease

One of the more obvious problems with individuals smoking or eating marijuana is that they might be too high to make love or have a decreased libido. Men who use may partake with their wife or partner and both may not ‘feel the love’ to conceive naturally.

Female ovulation

High amounts of THC can decrease estrogen production and delay or impede ovulation. In a small study, 29 out of 201 women who smoked marijuana had delayed ovulation of between 1.7 to 3.5 days.

Can marijuana help fertility?

Many individuals use marijuana because it helps decrease their stress or sleep better, all of which can help individuals during their fertility experience. This is another area that needs further fact-finding, though given the possible other negative effects, it is unlikely to be overall helpful.

Marijuana and pregnancy

An increasing number of females are smoking cannabis or taking edibles during their pregnancies. Some women use it during the first trimester of pregnancy because they may not know they are pregnant, or they continue to use it to cope with a chronic condition like a stress disorder. Others take it to help with morning sickness.

Kaiser Permanente researchers found pot use in pregnancy nearly doubled from four to seven percent between 2009-2016 and was most common during the first trimester.

Some studies have found a link between marijuana use during pregnancy, which crosses the placenta, and increased chances of miscarriage, premature birth, and low birth weight.  But like other aspects of research associated with marijuana, there have not been enough examinations separating variables so that medical professionals can ascertain what, if any, amount or form of cannabis pregnant women can use during gestation.

Better safe than sorry

Because the research is inclusive and, sometimes contradictory, doctors advise parents-to-be to stop using cannabis in any form while they are trying to get pregnant and while pregnant. Though recent research has indicated that marijuana has more of an impact on men and women with pre-existing fertility conditions, it is better to be safe than sorry during your pre-conception preparation.