Drug abuse and fertility: analytical insights into health service consumers’ decisions

Abstract Purpose The proposed study addresses how drug abuse (opioids, marijuana, stimulants, and alcohol) affects fertility and evaluates the patient experience, awareness, and coping behavior, which can affect access to fertility treatment at Al-Sadr Teaching Hospital in Najaf, Iraq. Methods A cross-sectional observational study was carried out in the period between January and June 2024 with 482 participants (both males and females) who are infertile and were recruited through the convenience sampling method. The data were gathered with the help of structured questionnaires about substance use and reproductive health, and clinical and laboratory tests, such as semen analysis, hormonal levels, and ovarian reserve. Statistical analysis was done through SPSS, that is, regression analysis and group analysis. Main outcome measures Fertility measures (men and women) such as sperm count, motility, hormonal levels, menstrual regularity, ovulation timing, and ovarian reserve were evaluated according to the nature, duration, and frequency of substance use. Findings There were significant negative correlations between fertility and substance use. Chronic opioid or stimulant use in men was associated with low sperm count and motility and hypogonadotropic testosterone levels. Alcohol and cannabis use in women were linked to menstrual abnormalities, delayed ovulation, and low ovarian reserve. A regression analysis proved that there existed a significant correlation between the duration and frequency of substance use and the severity of fertility impairment ( p < 0.01). Patient involvement in fertility services was conditioned by behavioral awareness, which enhanced treatment and lifestyle change adherence. Conclusions Drug abuse has adverse effects on fertility in terms of biological, behavioral, and sociocultural effects. To improve the decision-making process and reproductive outcomes, the notion of patient education combined with behavioral counseling and culturally sensitive interventions should be incorporated into the clinical practice of fertility care. Reproductive functionality can be partially restored by early stopping of substance use.