Table 2 Effects of psychoactive drugs on male fertility

Stimulants

 Methamphetamine

Suppression of circulating testosterone, distortion of testicular histoarchitecture (tubular degeneration and interstitial edema), apoptosis of germ cells

[18, 23, 53, 80, 104]

 Coccaine

Epigenetic modification

[78]

Depressants

 Alcohol

Suppression of hypothalamic-pituitary–testicular axis, sexual dysfunction, impairment of testosterone biosynthesis and spermatogenesis, testicular shrinkage

[10, 28, 33, 40, 47, 85]

 Rohypnol

Suppression of hypothalamic-pituitary–testicular axis, sexual dysfunction, reduced sperm quality

[81]

Opioids/narcotics

 Codeine

Suppression of hypothalamic-pituitary–testicular axis, reduced circulating testosterone, testicular and sperm oxidative damage, testicular cytoprotective and spermatogenic genes reprogramming

[5, 7, 8, 12, 13, 77]

 Morphine

Distortion of testicular histoarchitecture

[98, 102]

 Tramadol

Reduced sperm quality, distortion of testicular histoarchitecture

[20, 37, 41, 79, 93]

Hallucinogens

 Ketamine

Reduced testicular weight and distortion of testicular histoarchitecture, impairment of spermatogenesis, reduced sperm quality, reduced circulating testosterone, impaired male sexual behaviour

[36, 84, 87, 100]

 Cannabis

Reduced circulating gonadotropins and testosterone, testicular damage, reduced sperm quality

[16, 17, 71, 94]