{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T15:14:33Z","timestamp":1793459673089,"version":"4.5.0"},"reference-count":31,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2021,1,1]],"date-time":"2021-01-01T00:00:00Z","timestamp":1609459200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Therapeutic Advances in Urology"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:sec><jats:title>Aims:<\/jats:title><jats:p> To assess if marijuana consumption \u2013 prevalent among men of reproductive age and becoming widespread due to decriminalization \u2013 is associated with changes in semen parameters. Marijuana\u2019s active metabolite, tetrahydrocannabinol, can alter signaling pathways within spermatozoa, affecting spermatogenesis and fertility. <\/jats:p><\/jats:sec><jats:sec><jats:title>Methods:<\/jats:title><jats:p> We prospectively evaluated semen analyses (SA) from men presenting for infertility evaluation at one institution from July 2017 to April 2018. Participants completed a reproductive health questionnaire including items regarding marijuana consumption. SA was performed in accordance with World Health Organization (WHO) 5th Edition criteria. SA parameters included volume (ml), concentration (million\/ml), motility (%), progressive motility (%), and Tygerberg strict morphology (%). <\/jats:p><\/jats:sec><jats:sec><jats:title>Results:<\/jats:title><jats:p> A total of 409 patients completed the questionnaire; 174 (43%) men reported marijuana use (ever-users). Current and past users comprised 71 (17%) and 103 (25%), respectively. Compared with never-users, current and past users had a significantly higher likelihood of abnormal sperm strict morphology (33.1% versus 50.7% and 53.4%, respectively; p\u2009&lt;\u20090.001). However, sperm motility was more likely to be less than WHO reference values in never-users than current and past-users (38.3% versus 21.1% and 27.2%, respectively; p\u2009=\u20090.01). In multivariate logistic regression analyses, current use was associated with increased odds of abnormal strict morphology [odds ratio (OR) 2.15, 95% confidence interval (CI): 1.21\u20133.79] and semen volume less than WHO reference value (OR 2.76, 95%CI: 1.19\u20136.42), while odds of less than WHO reference value sperm motility were reduced (OR 0.47, 95%CI: 0.25\u20130.91). <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion:<\/jats:title><jats:p> Marijuana use is common among men presenting for fertility evaluation, and may have a detrimental effect on semen quality, particularly morphology and volume, but may be protective against abnormal sperm motility. Large, prospective studies of both semen quality and fertility in this growing, at-risk population are warranted. <\/jats:p><\/jats:sec>","DOI":"10.1177\/17562872211032484","type":"journal-article","created":{"date-parts":[[2021,7,21]],"date-time":"2021-07-21T06:30:23Z","timestamp":1626849023000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":27,"title":["Evaluation of the impact of marijuana use on semen quality: a prospective analysis"],"prefix":"10.1177","volume":"13","author":[{"given":"Marah C.","family":"Hehemann","sequence":"first","affiliation":[{"name":"Department of Urology, University of Washington, Seattle, WA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6117-116X","authenticated-orcid":false,"given":"Omer A.","family":"Raheem","sequence":"additional","affiliation":[{"name":"Department of Urology, Tulane University Medical Center, 1415 Tulane Avenue, 3rd Floor, New Orleans, LA 70112, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saneal","family":"Rajanahally","sequence":"additional","affiliation":[{"name":"Department of Urology, Baylor College of Medicine, Houston, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Holt","sequence":"additional","affiliation":[{"name":"Department of Urology, University of Washington, Seattle, WA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tony","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Urology, University of Washington, Seattle, WA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6190-2409","authenticated-orcid":false,"given":"Judy N.","family":"Fustok","sequence":"additional","affiliation":[{"name":"Department of Urology, Tulane University, New Orleans, LA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly","family":"Song","sequence":"additional","affiliation":[{"name":"Male Fertility Lab, University of Washington, Seattle, WA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather","family":"Rylander","sequence":"additional","affiliation":[{"name":"Male Fertility Lab, University of Washington, Seattle, WA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma","family":"Chow","sequence":"additional","affiliation":[{"name":"Male Fertility Lab, University of Washington, Seattle, WA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin A.","family":"Ostrowski","sequence":"additional","affiliation":[{"name":"Evergreen Health Urology and Urogynecology Care, Kirkland, WA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles H.","family":"Muller","sequence":"additional","affiliation":[{"name":"Department of Urology, University of Washington, Seattle, WA, USA Male Fertility Lab, University of Washington, Seattle, WA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas J.","family":"Walsh","sequence":"additional","affiliation":[{"name":"Department of Urology, University of Washington, Seattle, WA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,7,20]]},"reference":[{"key":"bibr1-17562872211032484","unstructured":"UNODC. 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