Recreational Drug Misuse and Its Potential Contribution to Male Fertility Levels’ Decline: A Narrative Review
Abstract
:1. Introduction
1.1. Psychoactive Substances’ Intake and Related Medical Untoward Consequences; Male Infertility: Definition, Causes, and Risk Factors
1.2. Drug Use as a Risk Factor for Male Infertility
2. Materials and Methods
2.1. Screening and Selection Process
2.2. Inclusion and Exclusion Criteria
2.3. Data Analysis and Presentation
3. Results
3.1. Cannabis
3.2. Opiates/Opioids
3.3. Cocaine
3.4. Amphetamine-Type Stimulants (ATS)
3.5. Novel Psychoactive Substances (NPS); ‘Herbal Highs’; and Psychedelics
4. Discussion
4.1. Male Infertility Measurement; Methodological Issues
4.2. Strengths and Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Drug | Author | Year | Country | Study Design | Sample Size | Population Description | Outcomes Being Analyzed | Main Findings |
---|---|---|---|---|---|---|---|---|
Cannabis | Hehemann et al. | 2021 | U.S. | Prospective | 409 | 71 current users 103 past users | Semen quality | Current use was associated with increased odds of abnormal morphology [OR 2.15, 95%CI: 1.21–3.79] and abnormal semen volume (OR 2.76, 95%CI: 1.19–6.42), while odds of less than WHO reference value sperm motility were reduced (OR 0.47, 95%CI: 0.25–0.91) |
Cannabis | Carroll et al. | 2020 | Jamaica | Cross-sectional | 229 | 47% current users | Semen quality | Recent- and large-quantity use were 2.6 times (OR 2.6; 95%CI, 1.0–6.8) and 4.3 times (OR 4.3; 95%CI, 1.1–15.9) at greater risk of asthenozoospermia. Moderate quantity users were 3.4 times (OR 3.4; 95%CI, 1.5–7.9) more likely to be diagnosed with teratozoospermia |
Cannabis | Gundersen et al. | 2015 | Denmark | Prospective | 1215 | 45% recent users | Semen quality, reproductive hormone levels | Regular marijuana smoking associated with a 28% (95%CI: −48, −1) lower sperm concentration and a 29% (95%CI: −46, −1) lower total sperm count. The combined use of marijuana and other recreational drugs reduced the sperm concentration by 52% (95%CI: −68, −27) and total sperm count by 55% (95%CI: −71, −31). Marijuana smokers had higher levels of testosterone |
Cannabis | Nassan et al. | 2019 | U.S. | Cross-sectional | 662 | 365 patients never used cannabis | Semen quality, reproductive hormone levels | Men who had ever smoked marijuana had significantly higher sperm concentration (62.7 million/mL (95%CI: 56.0, 70.3)) than men who had never smoked marijuana ((45.4 million/mL (38.6, 53.3)). No significant differences in sperm concentration between current and past marijuana smokers. A similar pattern was observed for total sperm count. Marijuana smokers had significantly lower FSH concentrations than never marijuana smokers |
Opiates/opioids | Nazmara et al. | 2020 | Iran | Case-control | 48 | 24 addicted 24 healthy controls | Semen quality, levels of protamine-2gene and miRNA-122 in seminal plasma | White blood cell count in semen (1.69 ± 0.41 vs. 8.61 ± 1.73, p = 0.001), motility (65.51 ± 2.57 vs. 41.96 ± 3.58, p = 0.001) and survival rate (87.41 ± 1.00 vs. 71.50 ± 4.59, p = 0.002) of sperm cells was significantly different between the healthy and addicted groups. Protamine-2 gene and protein expression in the addicted group were significantly lower than the healthy group, whilst seminal miRNA-122 levels in addicted men were higher than in healthy men |
Opiates/opioids | Nazmara et al. | 2019 | Iran | Case-control | 50 | 25 heroin abusers 25 healthy controls | Semen quality, sexual hormones levels, sperm histone replacement abnormalities | Sperm motility, viability, and sperm histone replacement abnormalities were significantly different in addicted group vs. non-exposed ones (p < 0.05). Serum sex hormone levels were not significantly different between groups |
Opiates/opioids | Safarinejad et al. | 2012 | Iran | Case-control | 288 | 142 heroin abusers 146 healthy controls | Semen quality, sperm function, seminal plasma antioxidant capacity, sperm DNA integrity | The mean ± SD sperm concentration in opiate users and in control subjects was 22.2 ± 4.4 and 66.3 ± 8.3 million per ml, respectively (p = 0.002). A significant increase in the amount of fragmented DNA was found in opiate consumers compared with that in controls (36.4 ± 3.8% vs. 27.1 ± 2.4%, p = 0.004). Significantly decreased levels of catalase-like and superoxide dismutase-like activity were observed in heroin abusers |
Opiates | Bassiony et al. | 2020 | Egypt | Case-control | 90 | 60 tramadol abusers 30 healthy controls | Semen quality, sexual hormones levels | Tramadol abusers had higher prolactin and lower free testosterone levels and they were more likely to have lower sperm counts and higher levels of abnormal motility and abnormal sperm morphology |
Amphetamine-type stimulants (ATS) | Pham et al. | 2022 | U.S. | Retrospective cohort study | 8861 | 106 men out of the total were prescribed with stimulants for ADHD | Semen quality | Stimulant use was associated with reduced total motile sperm count in the setting of decreased semen volume, but not sperm concentration, motility and morphology |
Amphetamine-type stimulants (ATS) | Shalev et al. | 2021 | Israel | Retrospective cohort study | 9769 | 293 men out of the total were prescribed with methylphenidate | Semen quality | Methylphenidate exposure did not affect sperm morphology but was associated with increased sperm concentration as well as increased total sperm count and total sperm motility among current and past users |
Herbal highs/Khat | Hakim et al. | 2002 | Ethiopia | Prospective cross-sectional | 214 | 184 khat users 30 healthy controls | Semen quality | No statistically significant difference in seminal quality parameters between groups |
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Schifano, N.; Chiappini, S.; Mosca, A.; Miuli, A.; Santovito, M.C.; Pettorruso, M.; Capogrosso, P.; Dehò, F.; Martinotti, G.; Schifano, F. Recreational Drug Misuse and Its Potential Contribution to Male Fertility Levels’ Decline: A Narrative Review. Brain Sci. 2022, 12, 1582. https://doi.org/10.3390/brainsci12111582
Schifano N, Chiappini S, Mosca A, Miuli A, Santovito MC, Pettorruso M, Capogrosso P, Dehò F, Martinotti G, Schifano F. Recreational Drug Misuse and Its Potential Contribution to Male Fertility Levels’ Decline: A Narrative Review. Brain Sciences. 2022; 12(11):1582. https://doi.org/10.3390/brainsci12111582
Chicago/Turabian StyleSchifano, Nicolò, Stefania Chiappini, Alessio Mosca, Andrea Miuli, Maria Chiara Santovito, Mauro Pettorruso, Paolo Capogrosso, Federico Dehò, Giovanni Martinotti, and Fabrizio Schifano. 2022. "Recreational Drug Misuse and Its Potential Contribution to Male Fertility Levels’ Decline: A Narrative Review" Brain Sciences 12, no. 11: 1582. https://doi.org/10.3390/brainsci12111582
APA StyleSchifano, N., Chiappini, S., Mosca, A., Miuli, A., Santovito, M. C., Pettorruso, M., Capogrosso, P., Dehò, F., Martinotti, G., & Schifano, F. (2022). Recreational Drug Misuse and Its Potential Contribution to Male Fertility Levels’ Decline: A Narrative Review. Brain Sciences, 12(11), 1582. https://doi.org/10.3390/brainsci12111582