Effects of recreational cannabis on testicular function in primary infertile men.
cannabis
male infertility
testosterone
Journal
Andrology
ISSN: 2047-2927
Titre abrégé: Andrology
Pays: England
ID NLM: 101585129
Informations de publication
Date de publication:
09 2022
09 2022
Historique:
revised:
07
07
2022
received:
18
05
2022
accepted:
18
07
2022
pubmed:
23
7
2022
medline:
23
8
2022
entrez:
22
7
2022
Statut:
ppublish
Résumé
Male factor contributes to up to 50% of cases of couples experiencing infertility. Cannabis is one of the most commonly used recreational drugs, and its effects on the reproductive system have been largely debated in the literature. The aim of this study is to evaluate the effect of recreational cannabis use on total T (tT) levels, gonadal status, and sperm parameters in a cohort of primary infertile non-Finnish, white-European men. Data of 2074 white-European men visited for primary couple's infertility were analyzed. Lifestyle factors and cannabis use were investigated in all participants. Semen analyses were based on the 2010 World Health Organization reference criteria. Serum hormones were evaluated, and patients were subdivided based on their gonadal status. Health-significant comorbidities were scored with the Charlson Comorbidity Index (CCI). Descriptive statistics and linear regression analyses were used to test the association between cannabis use, sperm parameters, and hormonal levels. Logistic regression analyses tested potential predictors for abnormal sperm parameters and gonadal status. Of 2074, 225 (10.9%) patients reported cannabis use in their lifetime. Total Testosterone levels were lower in cannabis users compared to nonusers (p = 0.03). In a multivariable linear regression analysis, cannabis use was inversely associated with tT levels (ß = -0.372 ng/ml; p = 0.005) but not with follicle-stimulating hormone nor with luteinizing hormone levels. Conversely, at multivariable logistic regression model cannabis use was not associated with the type of hypogonadism. At multivariable linear regression analysis, cannabis use was inversely associated with sperm morphology (p = 0.007), while not with both sperm concentration and sperm motility. Similarly, at adjusted logistic regression analysis cannabis use resulted associated with teratozoospermia (p = 0.039) but not with oligo-, astheno-, and azoospermia. Infertile men using cannabis are at higher risk of having lower testosterone levels and altered sperm morphology as compared with nonusers.
Sections du résumé
BACKGROUND
Male factor contributes to up to 50% of cases of couples experiencing infertility. Cannabis is one of the most commonly used recreational drugs, and its effects on the reproductive system have been largely debated in the literature.
OBJECTIVES
The aim of this study is to evaluate the effect of recreational cannabis use on total T (tT) levels, gonadal status, and sperm parameters in a cohort of primary infertile non-Finnish, white-European men.
MATERIALS AND METHODS
Data of 2074 white-European men visited for primary couple's infertility were analyzed. Lifestyle factors and cannabis use were investigated in all participants. Semen analyses were based on the 2010 World Health Organization reference criteria. Serum hormones were evaluated, and patients were subdivided based on their gonadal status. Health-significant comorbidities were scored with the Charlson Comorbidity Index (CCI). Descriptive statistics and linear regression analyses were used to test the association between cannabis use, sperm parameters, and hormonal levels. Logistic regression analyses tested potential predictors for abnormal sperm parameters and gonadal status.
RESULTS
Of 2074, 225 (10.9%) patients reported cannabis use in their lifetime. Total Testosterone levels were lower in cannabis users compared to nonusers (p = 0.03). In a multivariable linear regression analysis, cannabis use was inversely associated with tT levels (ß = -0.372 ng/ml; p = 0.005) but not with follicle-stimulating hormone nor with luteinizing hormone levels. Conversely, at multivariable logistic regression model cannabis use was not associated with the type of hypogonadism. At multivariable linear regression analysis, cannabis use was inversely associated with sperm morphology (p = 0.007), while not with both sperm concentration and sperm motility. Similarly, at adjusted logistic regression analysis cannabis use resulted associated with teratozoospermia (p = 0.039) but not with oligo-, astheno-, and azoospermia.
CONCLUSIONS
Infertile men using cannabis are at higher risk of having lower testosterone levels and altered sperm morphology as compared with nonusers.
Substances chimiques
Testosterone
3XMK78S47O
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1172-1180Informations de copyright
© 2022 American Society of Andrology and European Academy of Andrology.
Références
World Health Organization. Infertility definitions and terminology. Accessed April 1, 2022. http://www.who.int/reproductivehealth/topics/infertility/definitions
Minhas S, Bettocchi C, Boeri L, et al. European Association of Urology guidelines on male sexual and reproductive health: 2021 update on male infertility. Eur Urol. 2021;80(5):603-620. https://doi.org/10.1016/j.eururo.2021.08.014
Boeri L, Capogrosso P, Ventimiglia E, et al. Heavy cigarette smoking and alcohol consumption are associated with impaired sperm parameters in primary infertile men. Asian J Androl. 2019;21(5):478-485. https://doi.org/10.4103/aja.aja_110_18
Fallara G, Cazzaniga W, Boeri L, et al. Male factor infertility trends throughout the last 10 years: report from a tertiary-referral academic andrology centre. Andrology. 2021;9(2):610-617. https://doi.org/10.1111/andr.12947
Belladelli F, Boeri L, Capogrosso P, et al. Substances of abuse consumption among patients seeking medical help for uro-andrological purposes: a sociobehavioral survey in the real-life scenario. Asian J Androl. 2021;23(5):456-461. https://doi.org/10.4103/aja.aja_13_21
Salonia A, Rastrelli G, Hackett G, et al. Paediatric and adult-onset male hypogonadism. Nat Rev Dis Primer. 2019;5(1):38. https://doi.org/10.1038/s41572-019-0087-y
United Nations Office on Drugs and Crime. World Drug Report. United Nations Office on Drugs and Crime; 2019.
Mechoulam R, Parker LA. The endocannabinoid system and the brain. Annu Rev Psychol. 2013;64:21-47. https://doi.org/10.1146/annurev-psych-113011-143739
Rossato M, Pagano C, Vettor R. The cannabinoid system and male reproductive functions. J Neuroendocrinol. 2008;20 Suppl 1:90-93. https://doi.org/10.1111/j.1365-2826.2008.01680.x
Vescovi PP, Pedrazzoni M, Michelini M, Maninetti L, Bernardelli F, Passeri M. Chronic effects of marihuana smoking on luteinizing hormone, follicle-stimulating hormone and prolactin levels in human males. Drug Alcohol Depend. 1992;30(1):59-63. https://doi.org/10.1016/0376-8716(92)90036-c
Pacey AA, Povey AC, Clyma JA, et al. Modifiable and non-modifiable risk factors for poor sperm morphology. Hum Reprod Oxf Engl. 2014;29(8):1629-1636. https://doi.org/10.1093/humrep/deu116
Gundersen TD, Jørgensen N, Andersson AM, et al. Association between use of marijuana and male reproductive hormones and semen quality: a study among 1,215 healthy young men. Am J Epidemiol. 2015;182(6):473-481. https://doi.org/10.1093/aje/kwv135
Lisano JK, Smith JD, Mathias AB, et al. Performance and health-related characteristics of physically active males using marijuana. J Strength Cond Res. 2019;33(6):1658-1668. https://doi.org/10.1519/JSC.0000000000002238
Nassan FL, Arvizu M, Mínguez-Alarcón L, et al. Marijuana smoking and markers of testicular function among men from a fertility centre. Hum Reprod Oxf Engl. 2019;34(4):715-723. https://doi.org/10.1093/humrep/dez002
Salonia A, Matloob R, Gallina A, et al. Are infertile men less healthy than fertile men? Results of a prospective case-control survey. Eur Urol. 2009;56(6):1025-1031. https://doi.org/10.1016/j.eururo.2009.03.001
Del Giudice F, Kasman AM, Ferro M, et al. Clinical correlation among male infertility and overall male health: a systematic review of the literature. Investig Clin Urol. 2020;61(4):355-371. https://doi.org/10.4111/icu.2020.61.4.355
Belladelli F, Del Giudice F, Kasman A, Salonia A, Eisenberg ML. The association between testosterone, estradiol and their ratio and mortality among US men. Andrologia. 2021;53(4):e13993. https://doi.org/10.1111/and.13993
Boeri L, Capogrosso P, Ventimiglia E, et al. Testicular volume in infertile versus fertile white-European men: a case-control investigation in the real-life setting. Asian J Androl. 2021;23(5):501-509. https://doi.org/10.4103/aja.aja_93_20
Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40(5):373-383. https://doi.org/10.1016/0021-9681(87)90171-8
Tajar A, Forti G, O'Neill TW, et al. Characteristics of secondary, primary, and compensated hypogonadism in aging men: evidence from the European male ageing study. J Clin Endocrinol Metab. 2010;95(4):1810-1818. https://doi.org/10.1210/jc.2009-1796
Ventimiglia E, Ippolito S, Capogrosso P, et al. Primary, secondary and compensated hypogonadism: a novel risk stratification for infertile men. Andrology. 2017;5(3):505-510. https://doi.org/10.1111/andr.12335
Cooper TG, Noonan E, von Eckardstein S, et al. World Health Organization reference values for human semen characteristics. Hum Reprod Update. 2010;16(3):231-245. https://doi.org/10.1093/humupd/dmp048
Schlegel PN, Sigman M, Collura B, et al. Diagnosis and treatment of infertility in men: AUA/ASRM guideline part I. Fertil Steril. 2021;115(1):54-61. https://doi.org/10.1016/j.fertnstert.2020.11.015
Cazzaniga W, Candela L, Boeri L, et al. The impact of metabolically healthy obesity in primary infertile men: Results from a cross-sectional study. Andrology. 2020;8(6):1762-1769. https://doi.org/10.1111/andr.12861
Pozzi E, Boeri L, Capogrosso P, et al. Infertility as a proxy of men's health: still a long way to go. Turk J Urol. 2021. https://doi.org/10.5152/tud.2021.20561
Battista N, Rapino C, Di Tommaso M, Bari M, Pasquariello N, Maccarrone M. Regulation of male fertility by the endocannabinoid system. Mol Cell Endocrinol. 2008;286(1-2 Suppl 1):S17-S23. https://doi.org/10.1016/j.mce.2008.01.010
Belladelli F, Del Giudice F, Kasman A, et al. The association between cannabis use and testicular function in men: a systematic review and meta-analysis. Andrology. 2021;9(2):503-510. https://doi.org/10.1111/andr.12953
Fantus RJ, Lokeshwar SD, Kohn TP, Ramasamy R. The effect of tetrahydrocannabinol on testosterone among men in the United States: results from the National Health and Nutrition Examination Survey. World J Urol. 2020;38(12):3275-3282. https://doi.org/10.1007/s00345-020-03110-5
Kolodny RC, Masters WH, Kolodner RM, Toro G. Depression of plasma testosterone levels after chronic intensive marihuana use. N Engl J Med. 1974;290(16):872-874. https://doi.org/10.1056/NEJM197404182901602
Cushman P. Plasma testosterone levels in healthy male marijuana smokers. Am J Drug Alcohol Abuse. 1975;2(2):269-275. https://doi.org/10.3109/00952997509002740
Verhaeghe F, Di Pizio P, Bichara C, et al. Cannabis consumption might exert deleterious effects on sperm nuclear quality in infertile men. Reprod Biomed Online. 2020;40(2):270-280. https://doi.org/10.1016/j.rbmo.2019.11.002
Badawy ZS, Chohan KR, Whyte DA, Penefsky HS, Brown OM, Souid AK. Cannabinoids inhibit the respiration of human sperm. Fertil Steril. 2009;91(6):2471-2476. https://doi.org/10.1016/j.fertnstert.2008.03.075
Barbonetti A, Vassallo MRC, Fortunato D, Francavilla S, Maccarrone M, Francavilla F. Energetic metabolism and human sperm motility: impact of CB₁ receptor activation. Endocrinology. 2010;151(12):5882-5892. https://doi.org/10.1210/en.2010-0484
Wenger T, Ledent C, Csernus V, Gerendai I. The central cannabinoid receptor inactivation suppresses endocrine reproductive functions. Biochem Biophys Res Commun. 2001;284(2):363-368. https://doi.org/10.1006/bbrc.2001.4977
List A, Nazar B, Nyquist S, Harclerode J. The effects of delta9-tetrahydrocannabinol and cannabidiol on the metabolism of gonadal steroids in the rat. Drug Metab Dispos Biol Fate Chem. 1977;5(3):268-272.