Factors associated with cannabis use among infertile patients and their partner

To characterize cannabis use and factors associated with use among couples presenting for infertility evaluation.

We conducted a cross-sectional, retrospective chart review of female patients with infertility and their male partners presenting to an academic fertility center from 2016 to 2021. Demographic and clinical factors associated with self-reported cannabis use were assessed using multivariable logistic regression. Semen parameters were compared by cannabis use in an exploratory analysis.

Among 1531 female patients, 4.4% reported cannabis use. Users were younger, had higher BMI, were less often married and more frequently nulliparous, and had higher rates of tobacco and alcohol use and anxiety/depression (all p < 0.05). In adjusted analyses, cannabis use was associated with younger age (OR = 0.92, 95% CI 0.87-0.97), lower odds of being married (OR = 0.33, 95% CI 0.19-0.60), and higher odds of tobacco use (OR = 3.93, 95% CI 2.08-7.18), alcohol use (OR = 2.62, 95% CI 1.35-5.61), and psychiatric diagnosis (OR = 2.67, 95% CI 1.59-4.52), as well as more recent year of presentation (OR = 1.34, 95% CI 1.16-1.55). Among 1472 male partners, 8.6% reported cannabis use. After adjustment, cannabis use was associated with lower odds of being married (OR = 0.47, 95% CI 0.29-0.78), and higher odds of tobacco use (OR = 3.05, 95% CI 1.95-4.72), psychiatric diagnosis (OR = 3.23, 1.75-5.72), and more recent year of presentation (OR = 1.30, 95% CI 1.16-1.46). Semen parameters did not differ significantly by cannabis use.

Cannabis use increased over the study period and clustered with other behavioral and psychosocial factors. Younger, non-married individuals and those reporting tobacco use or anxiety/depression may benefit from targeted cannabis screening and preconception counseling.