In chronic male users, which statement about marijuana and fertility is most accurate?

• A. Lower sperm count in some men
• B. Infertility in most men
• C. Abnormal sperm morphology in some men
• D. Increases fertility in some men

Answer: (A)

Marijuana affects male fertility through the endocannabinoid system, which plays a role in regulating the hypothalamic-pituitary-gonadal axis and testicular function. THC from cannabis binds to CB1 receptors in the brain and in the testes, potentially dampening GnRH release and lowering LH and FSH, which can reduce testosterone and disrupt spermatogenesis. In chronic male users, the most consistent finding is that some men have a lower sperm count, reflecting a real but not universal effect. The evidence is variable, and infertility isn’t shown to occur in most men; effects may be reversible after stopping use. So the statement that lower sperm count occurs in some men best captures the typical pattern seen in the data.