Cannabinoid Therapy Effects on Human Fertility
Does weed cause infertility? Some observational studies find that men who use cannabis more often have a semen analysis outside the normal range, while a North American study of couples trying to conceive found no clear link between a woman’s occasional use and her chance of getting pregnant [1][2]. There is no evidence that cannabis treats infertility. If you are trying to conceive, the decision about cannabis belongs in a conversation with a physician.
Built on five decades of peer-reviewed research: studies in people, laboratory work and reviews.
Maybe cannabis is what finally takes the edge off your pain, your anxiety or your sleepless nights, and now you are planning a pregnancy, or your partner is. Online, you will find both “cannabis causes infertility” and “cannabis helps you conceive.” Neither is accurate, and the gap between them leaves a lot of people quietly worried, or quietly guessing.
This page sets out what research in people has actually found, what comes only from lab dishes and animals, and what nobody knows yet. It also shows how long sperm take to form, what to raise with a fertility specialist, and when a medical cannabis evaluation makes sense, and when it does not.
What is infertility? Meaning, symptoms and how common it is
Infertility means not being able to get pregnant after one year or more of regular sex without contraception [5][6]. Doctors shorten that window with age: if the woman is 35 or older, an evaluation is usually suggested after six months of trying, and couples where the woman is older than 40 should consider seeking evaluation sooner still [5]. The World Health Organization describes it as a disease of the male or female reproductive system, not a personal failing, and not only a “women’s issue” [6].
How to say it: in-fer-TIL-ih-tee.
Infertility or subfertility?
Infertility
The clinical label used once a couple has tried for the full window: 12 months, or 6 months after 35, without a pregnancy [5]. It starts an evaluation; it does not mean pregnancy is impossible.
Subfertility
A word many clinicians use for a reduced, slower chance of conceiving rather than none at all. Most people who hear “infertility” are actually in this situation: it may take longer, and many conceive with or without treatment.
When to see a doctor
How old is the person trying to conceive?
Your age when you started trying – it sets how long doctors suggest waiting.
Under 35: the usual advice is to see a doctor after one year of regular sex without contraception [5]. Go sooner if periods are very irregular or absent, if there is a history of endometriosis or very painful periods, or after more than one miscarriage [5].
35 to 40: doctors suggest an evaluation after six months of trying, not a full year, because a woman’s chances of conceiving fall faster each year after 30 [5].
Over 40: there is no need to wait out a set window: couples where the woman is older than 40 should consider seeking evaluation and treatment right away [5].
Symptoms
Often the only sign is that pregnancy is not happening. Some underlying causes do show up, though [5]:
- Periods that are irregular, very far apart or absent. Infertility itself does not stop periods, but an ovulation problem behind it often changes them.
- Very painful periods or pain during sex, which can point to endometriosis.
- More than one miscarriage.
- In men: problems with erection or ejaculation, a lump, swelling or pain in the testicles, or past injury, surgery or cancer treatment in that area.
The WHO puts it at roughly one in every six people of reproductive age over a lifetime [6]. Men are a large part of that picture: a 2026 review counts 56.5 million men living with infertility worldwide in 2019, a rise of 76.9% since 1990 [3].
What causes infertility in men and women?
Pregnancy needs a chain of steps to work: an egg is released, sperm are made and delivered, the two meet in an open fallopian tube, and the embryo implants in the uterus. Infertility happens when one or more of those links breaks. Problems in the man are just as likely as problems in the woman, it is equally likely to be a mix of both, and in many couples no cause is found [7].
Ovulation
Eggs are not released regularly; polycystic ovary syndrome and hormone imbalances are common reasons [6].
Fallopian tubes
Blocked or scarred tubes stop the egg and sperm from meeting [6].
Endometriosis
Tissue like the uterine lining grows outside the uterus, causing pain and scarring [6].
Uterus
Fibroids and other uterine disorders can get in the way of implantation [6].
Sperm production and delivery
Low or absent sperm, abnormal shape or movement, or problems with ejaculation [6].
Unexplained
Tests come back normal for both partners, and the exact cause stays unknown [7].
How much infertility is male factor?
More than many couples assume. Federal researchers put it plainly: a problem in the man is just as likely as a problem in the woman [7]. Common male causes include a varicocele (enlarged veins in the scrotum), past injury to the testicles, cancer treatment, diabetes, infections, hormone or genetic disorders, and habits such as heavy drinking, smoking and steroid use [5]. That is why a semen analysis belongs at the start of an evaluation, not after the woman has had every test.
Is infertility genetic or hereditary?
Sometimes. Genetic and hormonal disorders are among the recognized causes of male infertility [5], and some conditions that affect fertility in women, such as polycystic ovary syndrome, are linked to hormone and endocrine problems [6]. Infertility as a whole does not simply “run in families,” though: most causes are not inherited, and a relative’s difficulty conceiving does not decide yours. If a close relative had early menopause, a genetic condition or repeated miscarriages, tell the doctor. It can change which tests come first.
Endometriosis and fertility
Endometriosis is one of the uterine disorders the WHO lists among female causes of infertility [6], and a history of endometriosis or very painful periods is a reason to see a doctor sooner rather than later [5]. It also sits at the center of the cannabis question for many readers, because pain is often why someone with endometriosis uses cannabis in the first place. That conflict, easing pain versus trying to conceive, is covered in its own section below.
Infertility among Black women
Studies point to higher rates of infertility among Black women, yet in a national survey only 7% of non-Hispanic Black women had ever seen a medical provider for help getting pregnant, compared with 13% of non-Hispanic White women [8]. Insurance plays a part: Medicaid covers a larger share of Black women of reproductive age, and coverage for fertility care through Medicaid is limited and depends on the state [8]. If you have been told to “just keep trying” past the windows above, asking for a referral is reasonable.
Can nicotine or common medicines cause infertility?
People often ask about cannabis in the same breath as other things they use every day. Here is what official sources and the research behind this page say about the most common ones. Whatever you read below, do not stop a prescribed medicine on your own: raise it with the doctor who prescribed it.
Does nicotine or smoking cause infertility?
Smoking is one of the lifestyle factors known to lower fertility in women and men [5][6]. In a small case-control study of 113 men, normal sperm shape was found in 5.02% of sperm among tobacco smokers versus 7.46% among non-smokers [9]. Nicotine replacement and vaping were not what that study measured.
Do not stop a prescribed medicine on your own, including a stop-smoking medicine. Ask the prescriber how it fits with trying to conceive.
Does Ozempic (semaglutide) cause infertility?
The label does not list infertility as an effect. It does advise women to stop semaglutide at least 2 months before a planned pregnancy, because the drug takes a long time to leave the body [10].
Do not stop a prescribed medicine on your own. Plan the timing with the prescriber.
Does Accutane (isotretinoin) cause infertility?
The concern with isotretinoin is pregnancy, not fertility: it carries a high risk of miscarriage and birth defects, so patients who can become pregnant must use two forms of birth control from 1 month before treatment until 1 month after it, under the iPLEDGE program [11]. The official patient information does not describe lasting infertility after stopping [11].
Do not stop a prescribed medicine on your own; tell the dermatologist if you plan to conceive.
Does spironolactone cause infertility?
Spironolactone can cause irregular periods, breast enlargement and, in men, difficulty getting or keeping an erection [12]. Those effects can make conceiving harder while you take it. The patient information asks you to tell your doctor if you plan to become pregnant [12].
Do not stop a prescribed medicine on your own. Your doctor can weigh alternatives with you.
Does lupus cause infertility?
Lupus and some lupus treatments can affect fertility over the long term. One lupus medicine, cyclophosphamide, may cause infertility, though not in every case [13]. The Lupus Foundation of America suggests talking with your doctor at least 3 to 6 months before you want to start trying [13].
Do not stop a prescribed lupus medicine on your own: a flare during pregnancy carries its own risks.
Trying to conceive and using cannabis: what fits your situation?
Twelve short questions about who is trying, for how long, and how cannabis fits in. You get a plain summary of what your answers mean and what to raise with a physician, not a diagnosis.
12 questions · about a minute · your answers stay in this browser
Why cannabis and fertility are linked: the endocannabinoid system
Your body makes its own cannabis-like messengers, called endocannabinoids, and the receptors they act on, CB1 and CB2, sit in the testes, in the epididymis (the coiled tube where sperm mature) and on sperm themselves [3][14]. The same system helps run the signal chain from the brain to the ovaries and testes that controls hormones, egg and sperm development [3][14]. THC from cannabis acts on those same receptors, which is why researchers expect it could interfere with reproduction. Expecting is not the same as showing, though, and most of the steps below were seen in lab dishes or animals rather than in people.
Mostly lab and animal
Hormone signals
Cannabinoids can damp the brain’s release of GnRH, the hormone that starts the chain leading to testosterone and sperm production [3].
Lab only
Sperm movement (CatSper)
In human sperm in a dish, both THC and CBD blocked CatSper, a calcium channel sperm need for the final burst of swimming before fertilization [15].
Early evidence in people
DNA marks in sperm
Cannabis use has been linked to changes in DNA methylation (chemical tags that switch genes on or off) in sperm; most of this work is still in animals, and human studies are small [16][14].
Seen in people
The sperm’s own system
A comparison of fertile and infertile men found differences in the endocannabinoid system of their sperm [17].
Animal only
Implantation
In mice bred without the CB1 receptor, pregnancy rates fell by 50%, and by 80% without both CB1 and CB2, a sign the system matters for an embryo settling into the uterus [4].
What the research shows, from strongest to weakest
The strongest kind of evidence, randomized trials that give one group cannabis and another a placebo, does not exist for fertility, and for good ethical reasons. What we have instead are studies that watch people who already use cannabis, reviews that pull those studies together, and lab and animal work that explains possible mechanisms. Each tells you something different.
| Level | What exists for fertility | What it can and cannot tell you |
|---|---|---|
| Studies in people | Semen analyses of men who do and do not use cannabis [1][9]; a preconception cohort of couples trying to conceive [2]; an IVF cohort [18]. | Shows links, not cause. People who use cannabis also differ in tobacco, alcohol and other habits. |
| Reviews | Narrative reviews of the endocannabinoid system in sperm and egg development, early pregnancy and inherited DNA marks [3][14][4][16][19]. | Summarize mixed evidence and propose mechanisms; they add no new patients. |
| Lab and animal | Human sperm and stem cells in a dish, cow egg-supporting cells, and knockout mice [15][20][21][22][4]. | Explains why scientists are concerned; cannot say what happens in a person who uses cannabis. |
Browse the studies yourself
Every study cited on this page, in plain words. Neutral results sit next to worrying ones, and studies that are not about cannabis are labeled as background.
Cannabis use and semen quality
Current and past users more often had sperm with abnormal shape, current users more often had low semen volume, and low sperm movement was less common in current users than in never-users [1].
Cannabis, tobacco and sperm
Normal sperm shape: 2.26% in cannabis smokers, 5.02% in tobacco smokers, 7.46% in non-smokers [9].
Cannabis and the chance of conceiving each cycle
Couples trying to conceive were followed over time; neither women’s occasional use nor men’s weekly use showed a clear difference in the chance of pregnancy per cycle [2].
Cannabis use and IVF outcome
Compared IVF results in patients who did and did not use cannabis; the authors did not find a clear difference in outcome [18].
The endocannabinoid system in fertile and infertile men
Sperm from infertile men showed differences in the endocannabinoid system compared with sperm from fertile men [17].
Phytocannabinoids and male fertility
Maps how cannabinoids act on hormones, sperm energy and sperm DNA, mostly from animal and lab data, and notes that a cannabis plant compound shrank endometriosis lesions in animals [3].
The endocannabinoid system in egg and sperm development
Describes how sperm form over about 74 days and advises men in infertile couples to stop smoking tobacco and cannabis at least three months before assisted reproduction [14].
Lipid messengers in early pregnancy
Reviews how endocannabinoids and related fats guide implantation, largely from mouse studies [4].
Psychoactive drugs and male fertility
Surveys cannabis alongside other drugs and urges caution for people trying to conceive because of possible harm to the testes [19].
Cannabis and inherited DNA marks
Weighs evidence that a father’s cannabis use changes DNA marks passed on through sperm; the authors call it inconclusive [16].
THC and CBD on a sperm calcium channel
Both compounds blocked CatSper, the channel that powers sperm’s final swimming burst, in a dish [15].
CB2 and lab-grown sperm stem cells
Activating CB2 helped stem cells develop toward early sperm cells, research aimed at future treatments, not at cannabis use [20].
THC and the cells around the egg
THC changed DNA methylation in cow granulosa cells, the cells that support a developing egg, but not their microRNAs [21].
THC-exposed sperm and early embryos
Sperm treated with THC in the lab lost some energy capacity, and embryos made with them had fewer cells [22].
Opioid use in women trying to conceive
Looked at prescription opioid pain medicines, not cannabis. Its findings are summarized under safety and interactions [23].
Air pollution and female infertility
Long-term exposure to air pollutants was examined as a risk for female infertility in Taiwan [24].
Past chlamydia infection and infertility
Higher chlamydia antibody levels were linked with infertility in US women of reproductive age [25].
How far men travel to see a fertility urologist
Mapped the distance and driving time North American men face to reach a reproductive urologist [26].
No studies of this type are cited on this page.
What kinds of studies is this evidence built on?
How to read it: each row is one kind of study, and the bar shows how many published studies on cannabinoids and fertility are of that kind. Stronger designs are at the top. Gray bars are commentary, lab and animal work, which cannot show what happens to people who use cannabis.
Show as a table
| Group | Kind of study | Studies |
|---|---|---|
| Design | Systematic reviews | 4 |
| Design | Clinical trials | 2 |
| Design | Cohort studies | 17 |
| Design | Case-control studies | 2 |
| Design | Cross-sectional studies | 5 |
| Design | Surveys | 1 |
| Design | Case reports | 1 |
| Design | Guidelines | 1 |
| Design | Narrative reviews | 52 |
| Design | Animal studies | 4 |
| Design | Cell and lab studies | 4 |
| Who was studied | People in clinical studies | 7 |
| Who was studied | People observed, not treated | 111 |
| Who was studied | Whole populations | 23 |
| Who was studied | Animals | 1 |
| Who was studied | Not classified | 16 |
How can cannabis affect male fertility?
The clearest human data come from semen analyses. In one study, men who used cannabis were compared with men who had never used it, and several measures were checked against the World Health Organization’s normal ranges [1]. It was a cross-sectional study, a single snapshot, so it shows a link, not proof that cannabis caused the difference. Notice that one result points the other way: that is what real data usually look like.
How often did men have a semen result outside the normal range?
How to read it: ● estimate · ━ likely range (95% CI) · │ no difference. Each row compares cannabis users with men who never used it [1].
Show as a table
| Measure | Odds ratio | 95% CI | Compared with |
|---|---|---|---|
| Abnormal strict morphology, current users | 2.15 | 1.21-3.79 | Never-users [1] |
| Abnormal strict morphology, past users | 2.26 | 1.37-3.73 | Never-users [1] |
| Semen volume below WHO reference, current users | 2.76 | 1.19-6.42 | Never-users [1] |
| Total motility below WHO reference, current users | 0.47 | 0.25-0.91 | Never-users [1] |
A second, smaller study compared three groups of men directly and points the same way for sperm shape. The share of normally shaped sperm was lowest in men who smoked cannabis, in the middle for tobacco smokers and highest for non-smokers [9]. Many men in real life smoke both, which makes it hard to separate the two.
How many sperm had a normal shape?
How to read it: each bar is the average share of normally shaped sperm in one group of men; a longer bar is better. Case-control study, 113 men [9].
Does that mean cannabis makes men infertile? Not on this evidence. A shape or volume result outside the normal range lowers the odds per attempt; it does not rule out pregnancy. And in the preconception study of couples, men’s weekly use did not show a clear difference in how quickly their partners conceived [2]. The two kinds of results do not contradict each other so much as measure different things.
Can cannabis affect female fertility, early pregnancy and miscarriage?
For women, the best data on cannabis and conception come from a North American preconception cohort: couples who were trying to get pregnant were enrolled before conceiving and followed cycle by cycle [2]. That design is stronger than asking people after the fact, and the result was reassuring in one narrow sense: no clear difference. It does not show that cannabis is safe to use while trying.
Did couples take longer to get pregnant?
How to read it: ● estimate · ━ likely range (95% CI) · │ no difference. A hollow dot means the range crosses “no difference” [2].
In the lab, THC changed DNA methylation in the cells that surround and support a developing egg, in cow cells, not in women [21]. Whether anything similar happens in human ovaries at the levels reached by real-world use has not been measured.
Early pregnancy and miscarriage
What is known about cannabis and the first weeks of pregnancy comes mainly from animal studies. In mice, the endocannabinoid system has to be tuned just right for an embryo to implant: mice lacking the CB1 receptor had 50% lower pregnancy rates, and those lacking both CB1 and CB2 had 80% lower rates [4]. THC acts on those same receptors, which is why researchers raise the question at all. These are reasons for caution, not measurements of risk in people who use cannabis.
Can infertility cause miscarriage?
Infertility and miscarriage are different problems, but they overlap. More than one miscarriage is itself a reason to seek a fertility evaluation [5], and some of the same causes, age, hormone and uterine problems, can make both conceiving and staying pregnant harder [5][6]. A miscarriage is not a sign that you did something wrong.
Does it matter if you smoke, vape, eat edibles or use CBD?
Almost all of the human fertility data come from people who smoke cannabis, and most studies simply record “use” without asking how. So the honest answer is layered: some concerns belong to smoke and vapor, some to THC in any form, and some products have barely been studied at all. Changing the form is not a way around the question; that decision belongs with a physician.
How is it used, or how would it be?
Choose the closest; most people combine more than one.
Specific to smoking
Joints, blunts, pipes and bongs burn plant material. This is the form nearly all human fertility studies describe, and the semen studies above were largely of men who smoked [9]. Blunts and many joints also contain tobacco, which lowers fertility on its own [5].
Specific to vaping and dabbing
Dry-herb vaporizers, oil pens and cartridges avoid burning, but hot vapor still travels the same airways. Concentrates used for dabbing, such as wax, shatter or rosin, carry far more THC per use. Vaping has not been studied separately for fertility.
Specific to edibles and capsules
Gummies, chocolates, drinks, capsules and swallowed oils avoid smoke entirely. They take longer to start working and last longer, and the THC passes through the liver before reaching the blood. They still deliver THC to the whole body, including the reproductive organs.
Specific to tinctures and sprays
Drops or oil held under the tongue and mouth sprays avoid the lungs. Part of each dose is still swallowed, and whatever is absorbed reaches the bloodstream like any other form.
Specific to topicals and patches
Creams and balms act mainly where they are applied. Transdermal patches are different: they are designed to deliver cannabinoids into the bloodstream, so they count the same as any other form for fertility.
Specific to CBD-only products
Products with CBD and no THC have very little fertility research in people. In the lab, CBD blocked the same sperm calcium channel as THC [15], so “no THC” does not mean “no effect”; it means largely unknown.
Specific to prescription cannabinoids
Dronabinol (Marinol, Syndros), nabilone (Cesamet) and cannabidiol (Epidiolex) are FDA-approved medicines prescribed by a doctor and filled at a pharmacy, not dispensary products bought with a medical card. If you take one, discuss pregnancy plans with the prescriber.
True of every form
- THC that reaches the blood reaches the CB1 and CB2 receptors in the testes, sperm and uterus [3][4].
- No form has been shown to be safe while trying to conceive or in pregnancy.
- Any form can interact with other medicines, including fertility drugs, which have not been studied with cannabis.
- The choice of form, or whether to pause, is a conversation with a physician, not something this page can settle.
All forms as a table
| Form | What it avoids | What remains |
|---|---|---|
| Smoking | Nothing | THC in the whole body, smoke, frequent tobacco mixing; the form most studies describe |
| Vaping and dabbing | Burning | THC in the whole body, hot vapor in the airways, high-strength concentrates |
| Edibles and capsules | Smoke and vapor | THC in the whole body, slower and longer effect, liver processing |
| Tinctures and sprays | Smoke and vapor | THC in the whole body; part of the dose is swallowed |
| Topicals | Most absorption into the blood | Little fertility data |
| Transdermal patches | Smoke and vapor | Cannabinoids delivered into the bloodstream |
| CBD only | THC | Lab effects on sperm; very little human data |
| Prescription cannabinoids | Unlabeled dosing | Prescription medicines; pregnancy plans go to the prescriber |
What the evidence can’t tell us yet
Anyone who tells you with certainty that cannabis does or does not affect your fertility is going further than the research. Here is where it runs out:
- Animals and people do not line up. Many of the most striking findings come from mice, cows and cells, and clinical studies in people have not consistently confirmed them [3].
- Doses are not sorted out. Studies rarely separate occasional medical use from heavy recreational use, so nobody can say whether a lower dose carries a lower risk [3].
- DNA-mark findings are early. Most evidence that cannabis changes inherited DNA marks comes from animals; human studies are small and have not followed the children [16].
- Real exposure is unmeasured. How much THC actually reaches semen or the fluid around an egg in people has never been measured, so lab concentrations may not match real life [15].
- Samples are small. The case-control semen study compared 113 men in three groups, too few to settle the question [9].
- Looking back misses things. Retrospective designs cannot fully account for smoking, weight or how hard a couple was trying to conceive, any of which could explain a link, a limit the authors of one fertility cohort spell out [24].
Planning pregnancy or IVF? How long to stop before trying
Sperm are not made overnight. It takes about 74 days for a sperm cell to develop from its earliest stage to release, according to a 2025 review [14]; another review puts one cycle at about 77 days [16]. That means the sperm in a sample today started forming roughly two and a half months ago. The authors of the 2025 review advise men in couples with infertility to quit smoking cigarettes and cannabis at least three months before assisted reproduction such as IVF [14].
That is a recommendation from reviewers for a specific group, not a rule tested in a trial, and no study has measured whether stopping for three months changes pregnancy rates. For women, there is no equivalent timeline in the research.
Days since the last use
Count from the last day the partner who produces sperm used cannabis in any form. Not stopped yet: leave it at zero.
Before day 74, the sperm being released began forming before the last use. Between day 74 and day 89, new sperm began forming after the last use. From day 90, you are past the three-month point the study authors name before assisted reproduction [14].
How to bring this up with your doctors
Tell the fertility clinic how often you or your partner use cannabis, in what form, and why: pain, anxiety, sleep. Clinicians ask about it because it can matter for treatment planning, not to judge. If cannabis is helping with a symptom, a physician who evaluates you for a medical card can talk through what else might manage that symptom while you try to conceive.
Can cannabis help with infertility or endometriosis?
There is no evidence that cannabis treats infertility or makes pregnancy more likely. No study on this page tested it for that, and the research that exists points to caution rather than benefit.
Endometriosis is a different question, because the main reason people use cannabis with it is pain. In animal studies, beta-caryophyllene, a compound found in cannabis and other plants, reduced endometriosis lesions by 52.5% [3] Animal only. That is a laboratory result in animals, not a treatment for women.
Pain relief is the realistic question, and it is a potential, not a promise: there are no trials of cannabis for endometriosis pain among the studies here. Chronic pain is a qualifying condition in many state programs, but relief from pain and trying to conceive can pull in opposite directions.
What matters most to you right now?
Pick the goal you would bring to the appointment.
Easing pain: ask what has the best evidence for your kind of pain, how cannabis would fit with your other medicines, and what you would watch to know whether it helps. Read more on chronic pain and medical cannabis.
Getting pregnant: ask your fertility specialist whether to pause cannabis, for how long, and whether your partner should too. Ask which tests to start with, including a semen analysis, and when.
Both: this is the hardest spot, and it deserves a plan rather than a guess. Ask both doctors to talk to each other: which pain options fit with trying to conceive, what to do during IVF cycles, and what to stop the moment a test is positive.
Coping with infertility: depression, anxiety and support
Month after month of hoping, testing and waiting wears people down. If you feel exhausted, angry, jealous of friends’ announcements or numb, you are not overreacting, and you are not alone in it.
Can infertility cause depression?
It can. The WHO notes that people living with infertility frequently experience emotional stress, depression, anxiety and low self-esteem, along with stigma and strain in relationships [6]. That stress is a consequence of a hard situation, not a sign of weakness, and it is treatable. If low mood lasts for weeks, or you have thoughts of harming yourself, talk to a doctor now, or call or text 988 in the US.
Ways people cope
- Naming a plan with a timeline: how long to try, when to see a specialist, so every month does not feel open-ended.
- Telling one or two people the truth, and choosing who does not need to know.
- Counseling with someone who works with fertility patients, alone or as a couple.
- Support groups, in person or online, where nobody needs the basics explained.
- Treating anxiety and sleep problems directly. Some people use cannabis for these; if you are trying to conceive, that is exactly the use to review with a physician. See anxiety, depression and insomnia and medical cannabis.
Food and everyday health
There is no fertility diet that guarantees a pregnancy. What is clear is that smoking, heavy drinking, and being underweight, overweight or obese all lower fertility, in women and in men [5]. Small, steady changes in those areas are worth more than any single “fertility food.”
National Infertility Awareness Week
Each April, National Infertility Awareness Week (founded in 1989 by RESOLVE: The National Infertility Association) focuses attention on infertility and on people living with it; in 2026 it ran April 19-25 [27]. It is a good time to find support groups and advocacy resources, though both are available all year.
Safety: side effects and drug interactions
When you are trying to conceive, “side effects” includes effects on fertility itself. Below are the medicines and substances most often combined with cannabis by people in this situation, and what is actually known.
Opioid pain medicines Clinical data
This is a study of opioids, not cannabis. In women trying to conceive, opioid use was linked to a lower chance of conceiving per cycle (odds ratio 0.71, 95% CI 0.50-1.00) and a higher risk of pregnancy loss (risk ratio 2.5, 95% CI 1.3-5.0) compared with no opioid use [23].
It matters here because many people use cannabis for the same pain that opioids treat, and some use both. Do not change an opioid dose on your own; tell your doctors about both.
Tobacco smoked with cannabis Clinical data
Fertility drugs and IVF hormones No data yet
No study has looked at cannabis together with ovulation drugs, injectable hormones or the medicines used during IVF. That absence is not reassurance. Tell the clinic about any cannabis use, in any form, before a cycle starts.
Antidepressants, anxiety and sleep medicines No data yet
Fertility studies have not tested cannabis alongside these medicines. THC and many of them can both cause drowsiness, so a physician should review the combination, and any plan to stop one, before you change anything.
The practical advice in the research is consistent: be cautious with cannabis while trying to conceive, because of possible harm to the testes and sperm [19], and for men in couples heading into assisted reproduction, stop smoking tobacco and cannabis at least three months beforehand [14].
Who should not use cannabis while trying to conceive
Some situations call for avoiding cannabis or getting a physician involved before using it:
- Anyone who is pregnant or breastfeeding.
- People actively trying to conceive or preparing for IVF or another fertility treatment, unless a physician has reviewed it with them.
- Men in couples heading into assisted reproduction, for whom reviewers advise stopping cannabis smoking at least three months before [14].
- Anyone taking opioid pain medicines without a doctor knowing about the cannabis.
- Anyone with a history of psychosis.
Talk to a licensed physician about whether any of these apply
Is infertility a qualifying condition for a medical card?
Infertility on its own is almost never on a state’s list of qualifying conditions, and given the research above, it would be odd if it were. What decides eligibility is your state’s list and the physician’s judgment about the conditions you do have, and people facing infertility often also live with chronic pain, endometriosis pain, anxiety or insomnia.
Infertility is named
Rare. Even then, a physician weighs whether cannabis makes sense while you are trying to conceive. Check your state’s rules.
A condition you also have is listed
The common route: chronic pain, anxiety or a sleep disorder, where your state lists them. See what your state lists.
Neither is listed
Some states let physicians recommend for other serious conditions; others do not. Start with your state’s medical marijuana laws.
What else has a doctor diagnosed?
State lists name diagnoses, not symptoms: pick what is in your records.
Chronic pain, including endometriosis pain: the most widely listed condition across state programs. Read chronic pain and medical cannabis.
Anxiety: several states list anxiety disorders or accept them under broader wording. Read anxiety and medical cannabis.
Depression: fewer states list it, and THC can affect mood in both directions. Read depression and medical cannabis.
Insomnia: a diagnosed sleep disorder is listed in some programs. Read insomnia and medical cannabis.
Anorexia: an eating disorder can itself stop ovulation, and some programs list it. Read anorexia and medical cannabis.
None of these: then the decision rests on your state’s wording and the physician’s judgment. Start with your state’s medical marijuana laws.
Medical card or recreational purchase
In states with adult-use sales, adults can buy without a card. A card still changes several things, though the details are set state by state: possession limits, taxes and home growing are listed for each state on the laws and regulations pages.
| Aspect | With a medical card | Recreational |
|---|---|---|
| Taxes | Often lower; some states waive part of the cannabis tax for patients | Full state and local cannabis taxes |
| Purchase and possession limits | Often higher; depends on your state | Set for adult-use buyers |
| Home cultivation | Allowed for patients in some states | Allowed for adults in some states; banned in others |
| Age | Patient age rules set by each program | Adult-use age limit set by the state |
| Physician involvement | A licensed physician reviews your conditions, medicines and pregnancy plans | None |
| Document | State card or recommendation, recorded in a confidential registry | Government ID only |
Will a card save you money?
It can, but only where your state taxes patients less than recreational buyers, and the amount depends on your state’s tax rates and how much you buy. Weigh that against the evaluation fee and any state registration fee. The breakdown by state is in medical vs. recreational cannabis taxes.
What the program in your state involves
Qualifying is the first of two steps. In most states a physician’s recommendation is followed by registration with the state health department, which issues the card and enters you in a confidential patient registry; in a few, the recommendation itself is what a dispensary asks for. Purchases happen at licensed dispensaries, and products there are lab-tested and labeled with their THC and CBD content.
Many state laws also let a patient name a registered caregiver who may buy and handle products on their behalf; who qualifies and how to register is set by each state. Cards from one state are not automatically valid in another; see which states accept out-of-state cards.
Renewing a card
Cards expire on a schedule set by each state, and renewing usually means a new evaluation. If your plans have changed since the last one, you are now trying to conceive, or starting IVF, that is exactly what to bring to the renewal appointment. How renewal works is laid out on the medical card pages for each state.
Legal protections: firearms, work and privacy
Federal law bars anyone who is an “unlawful user” of a controlled substance from having firearms [28], and how that applies to state medical cannabis patients has been shifting in the courts and in federal guidance; if you own or plan to buy a gun, ask a lawyer before you register. Workplace protections differ by state, and many employers can still test for THC. Your medical records are protected health information, and state patient registries are confidential, though who can query them is set by each state.
What this means if you are trying to conceive
A good evaluation is a conversation about one or two specific symptoms, the medicines already in use, your pregnancy plans and what would count as “better.” It goes faster, and safer, when the facts are on the table.
Which situation are you in?
What to bring to the appointment
Tap each item as you get it ready.
Questions worth asking
- Should I pause cannabis while we try, and does my partner need to as well?
- What else could manage my pain, anxiety or sleep during this time?
- How does cannabis fit with my current medicines and any fertility treatment?
- What should I stop as soon as a pregnancy test is positive?
- Should you and my fertility specialist be in touch?
An evaluation makes sense if
- You have a diagnosed condition such as chronic pain, anxiety or insomnia.
- You want a physician to review cannabis alongside your pregnancy plans.
- You live in a state with a medical cannabis program.
It is not the right step if
- You are pregnant or breastfeeding.
- You are hoping cannabis will help you get pregnant.
- You have any of the urgent symptoms below.
This page is an educational summary of published research, not medical advice. It does not replace an evaluation by a physician who knows your history.
How to get a medical card online
Everything happens online; there is nowhere to travel. Here is what each step involves and who is responsible for it.
Fill in a short form
Your state, your conditions and your medicines. About five minutes.
See a physician licensed in your state
A one-on-one appointment of about fifteen minutes; you agree on the time with the physician. Tell them about pregnancy plans and every medicine.
Get a signed recommendation
If you qualify, it usually arrives by email within one to two days after the appointment.
Register with your state
Where your state requires it, you register with its program, which issues the card. Timing is set by the state.
What you end up with
A recommendation from a physician licensed in your state, and, where the state issues one, a card from its program. The state’s own registration fee, if there is one, is paid to the state and is separate from the evaluation.
Across 250 reviews from patients in the states where we are licensed. We do not sort them by score and do not hide the low ones.
- 150,000+patients evaluated – everyone who has been through an appointment with us, in every state where we are licensed
- Since 2017doing only this: online evaluations for medical cannabis programs, and nothing else on the side
Already a patient? Sign in to your account. Want to know how an evaluation works before you begin? Read about getting a medical card or meet the physicians. There are also programs for veterans and for people on a low income.
The physician will take your pregnancy plans and current medicines into account, and may advise against cannabis while you are trying to conceive.
Questions people ask about infertility and cannabis
Does weed cause infertility?
Not in any proven way, but it is not off the hook either. In men, cannabis use has been linked to semen results outside the normal range, such as abnormal sperm shape [1]. In a preconception study of couples, occasional use by women showed no clear difference in the chance of conceiving per cycle [2]. These are links from observational studies, not proof of cause, and no study shows cannabis is safe while trying to conceive.
Does CBD-only affect fertility?
It is largely unknown. There is very little research on CBD and fertility in people. In a lab study, CBD blocked a calcium channel that sperm need to swim, as THC did [15] – a lab result, not a finding in people.
What about delta-8 THC and fertility?
None of the fertility studies on this page tested delta-8 THC. It acts on the same cannabinoid receptors as regular THC, so there is no reason to assume it is safer for fertility, and products sold outside licensed dispensaries vary widely in what they contain.
Can infertility in men be cured?
Often it can be treated. Medicines can correct some hormone problems, surgery can repair blocked sperm ducts or a varicocele, and when that does not restore fertility, assisted reproductive technology can be effective [29]. Whether a specific cause can be reversed depends on what it is.
How can infertility be treated?
Options include timed intercourse, medicines, intrauterine insemination (IUI), surgery and assisted reproductive technology such as IVF [5]. The right one depends on the cause, age and how long you have been trying.
How do you check for infertility? Do home kits work?
An evaluation usually covers both partners: a semen analysis for the man, and checks of ovulation, hormones, the uterus and fallopian tubes for the woman. Home ovulation kits and home sperm tests can give a first clue, but each measures only one thing and cannot replace a full evaluation.
Does infertility go away?
Sometimes. Some causes respond to treatment, and many couples labeled infertile after a year go on to conceive, with or without help. Others need assisted reproduction. Age matters: a woman’s chances fall faster each year after 30 [5].
Do Medicaid or Medicare cover infertility services?
There is no federal requirement for state Medicaid programs to cover fertility treatment, so coverage depends on your state: a few states cover some diagnostic costs, and coverage of treatment is rare [8]. Medicare covers services for infertility that it deems reasonable and necessary, but which ones is not clearly defined [8]. Call your plan and ask about testing and treatment separately.
Can infertility cause depression?
Yes. People living with infertility frequently experience stress, depression and anxiety [6]. Counseling and treatment help; if you have thoughts of harming yourself, call or text 988.
Is an online evaluation legitimate?
Yes, where state law allows it. Telemedicine evaluations are done by physicians licensed in your state, one on one, and the recommendation they sign is the same document an in-person visit would produce. Learn how it works on the medical card page.
Is my card valid in another state?
Only where that state accepts out-of-state cards, and the rules differ. See which states accept out-of-state medical marijuana cards.
What if my card is lost?
Most states let you request a replacement. The steps are in what to do if your medical card was lost.
Who finds out? Privacy, firearms and work
Your evaluation is private medical information, and state patient registries are confidential. Employers generally are not notified, though workplace protections differ by state. Federal law bars “unlawful users” of controlled substances from having firearms [28]; if that affects you, get legal advice before registering.
More research on cannabis and infertility
This page cites a selection of studies. Our research library holds every study we track on cannabis and infertility, from laboratory work to clinical trials, and lets you filter them by cannabinoid, study type and year.
- studies
- 270+
- in people
- 140+
- clinical trials
- 2