The growing concern

In the age of marijuana legalization, a troubling health concern is emerging—its impact on fertility. While cannabis enjoys increased social acceptance, its unintended consequences on reproductive health are often overlooked. Daily marijuana use now surpasses high-frequency alcohol consumption, marking a cultural shift that demands urgent attention. Yet, despite accumulating evidence, why does it feel like no one is listening?

As fertility specialists, we are witnessing an alarming trend: couples struggling to conceive without realizing marijuana might be playing a significant role. Partner use of cannabis has been linked to increased miscarriage rates, while male and female reproductive cells face serious harm. The science is clear, and public awareness is overdue.

Marijuana and your eggs: a silent assault

At the cellular level, marijuana’s active compound, THC (delta-9-tetrahydrocannabinol), disrupts critical processes essential for fertility. THC impairs mitochondrial function—the powerhouse of eggs—by reducing ATP (energy) production and increasing oxidative stress. Eggs require immense energy to mature, fertilize, and sustain early embryonic development. When THC damages mitochondria, it compromises egg quality, leading to infertility and potential pregnancy loss.

In addition, THC disrupts the hormonal signals (LH and FSH) that regulate ovulation, impairing egg release and follicle development. Imagine a finely tuned orchestra thrown into disarray—that’s the effect THC has on your reproductive system.

Sperm under siege

For men, marijuana’s effects are equally concerning. THC lowers sperm count, motility, and morphology—the trifecta of healthy sperm function. It also causes DNA fragmentation, increasing the risk of genetic abnormalities in offspring.

The culprit again? Mitochondrial dysfunction and oxidative stress. Sperm rely heavily on mitochondria for energy to swim toward and fertilize an egg. Without it, they become lethargic and fragmented. Alarmingly, research shows male fertility issues linked to marijuana use can persist for up to two years after quitting.

Marijuana and pregnancy: a risk to babies

The risks extend into pregnancy. THC crosses the placenta, potentially affecting fetal growth and brain development. Studies associate marijuana use during pregnancy with:

• Low birth weight
• Preterm delivery
• Cognitive and behavioral deficits in children

These findings raise an unsettling question: are we unintentionally compromising the next generation’s health?

Why aren’t we talking about this?

The science isn’t new. Experts like the American College of Obstetricians and Gynecologists (ACOG) and leading urologists have sounded the alarm: marijuana negatively impacts fertility and pregnancy outcomes. Studies in Human Reproduction and Reproductive Sciences confirm lower sperm quality, reduced testosterone levels, and impaired ovulation in cannabis users.

Yet, public conversations often focus on marijuana’s “natural” appeal or perceived safety. Few realize the profound impact it can have on their ability to start a family.

A call to action

The evidence is too compelling to ignore. Marijuana may be legal, but it is not harmless—especially for those trying to conceive. As physicians, we must bridge this knowledge gap. Public health campaigns, patient education, and open discussions are critical to reversing this trend.

If you or your partner use marijuana and are struggling with fertility, consider this: quitting could be the first step toward success.

It’s time to start listening.

Oluyemisi (Yemi) Famuyiwa is a renowned fertility specialist and founder, Montgomery Fertility Center, committed to guiding individuals and couples on their path to parenthood with personalized care. With a background in obstetrics and gynecology from Georgetown University Hospital and reproductive endocrinology and infertility from the National Institutes of Health, she offers cutting-edge treatments like IVF and genetic testing. She can be reached on Linktr.ee, LinkedIn, YouTube, Facebook, Instagram @montgomeryfertility, and X @MontgomeryF_C.