MARIJUANA, TESTOSTERONE AND ALCOHOL USE IN INDIVIDUALS SUBMITTING FELLOWTM MAIL-IN SEMEN ANALYSES: UTILIZING USER-REPORTED SURVEY DATA TO DESCRIBE CONTEMPORARY BEHAVIOR OF FERTILITY PATIENTS

Using survey data collected from a novel, nation-wide, mail-in semen analysis testing system, we sought to assess rates of marijuana (MJ), alcohol (ETOH) and testosterone supplementation (T) use by individuals across different stages in their fertility journey. Men that submitted Fellow Health mail-in semen analyses between September 2022 and March 2023, consented to participate, and completed a detailed sociodemographic and exposures survey were included in this study. Those that submitted samples after vasectomy or vasectomy reversal were excluded. Data were analyzed with STATA 16.1 and Chi-square used to assess statistical significance. Men (n=658) were evenly distributed between the West (29%), Southwest (18%), Midwest (19%), Southeast (29%); however, the Northeast was underrepresented (5%) (Table 1). Most were married (71%), completed at least some college (81%), earned more than $100K per year (55%), and identified as White race (82%). Among all participants, MJ use was reported in 24%, T in 4.6% and ETOH in 73%. Overall, in the entire subset of couples actively trying to conceive (n=597), significantly fewer used MJ (19% v. 40%, p<0.001). In this same group, no difference in ETOH use was reported (74% v. 76%, p=.49). For men trying for 1-6 months v. those not trying to conceive, no difference in MJ use was noted (25% v. 24%,p=.85). However, as time trying increased, fewer men used MJ; men trying 6-12 months reported 17% rate v. 26% trying for less time (p=-.01) and men trying 12+ months reported 15% v. 24% (p=.02). T use decreased significantly over time; many fewer men used T after trying for 12 months (1.2% vs. 6%, p=.01). Among the men trying only 1-6 months, no difference in T use observed (5.1% v. 7.3%, p=.46). MJ, T, and ETOH use are prevalent in patients submitting Fellow mail-in semen analyses. While rates of MJ and T use decline in this study as individuals progress along their fertility journey, rates of ETOH use do not.