Objective: Cannabis is an increasingly used recreational drug in the western world. Its constituent components are cannabinoids, the main ones of which aretetrahyrdocannabiol (THC), which is the psychoactive molecule and cannabidiol (CBD). CBD isprescribed in the United Kingdom in the treatment of conditions such as multiple sclerosis andepilepsy, and is freely available to purchase in various forumations.However, there is limiteddata assessing the link between cannabis use and fertility, and less specifically looking at the effect of CBD on fertility. The objective of this study was treviewthe effects of cannabidiol, THC and cannabis usage on fertility. 

Methods: A narrative literature search of the major databases (Pubmed, Medline,Google Scholar, Web of Science) was conducted using the words ‘cannabidiol, cannabis, marijuana, sperm, tetrahyrdocannabiol, and fertility’. Given the paucity of prospective data available quantitative analysis was not possible, sothe literature was critically reviewedto assess the impact on fertility. 

Results: Cannabis usage appears to negatively impactovulation,as well assemen parameters, including sperm count, concentration, morphology, motility, how this relates to conception is less well established with contrasting findings between studies. The data available for late pregnancy and neonatal outcomes is better established with a detrimental effect found with cannabis usage during pregnancy. 

Conclusions: There is a large gap in data relating to the effects of cannabis and CBD which in the context of declining fertility rates is a subject that warrants further study. In certain countries such as the United States and Canada there has been recent widespread legalisation of cannabis, highlighting the urgent need for such research. In the United Kingdom the increasing use of CBD formulations should prompt similar action as its effect are largely unknown, but appear deleterious.  

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