PURPOSE: Despite growing prevalence of cannabis use in the U.S., literature describing the impact of cannabis use on fertility is limited. This study investigates the association between frequency of cannabis use and female infertility. METHODS: We conducted a cross-sectional analysis of frequency of cannabis use and infertility (inability to conceive within a year) using the 2013-2018 National Health and Nutrition Examination Study (NHANES) for women aged 20-49. Multivariable logistic regression models adjusting for sociodemographics, health status, and other substance use were utilized to estimate adjusted odds ratios (aOR), 95 % confidence intervals (CI), and assess results by age of regular use initiation and marital status. RESULTS: Of the 3167 women included, 12.4 % reported infertility. Infertility prevalence was 10.6 % among those with irregular cannabis use and 15.4 % among those with regular use. Compared to never use, women with regular use had 53 % greater odds of infertility (aOR: 1.53
95 % CI: 0.91, 2.55) and women with irregular use had 17 % lower odds of infertility (aOR: 0.83
95 % CI: 0.54, 1.27), without statistical significance. Associations were robust to age of initiation of use and marital status. CONCLUSIONS: Our results suggest a possible modest association between regular cannabis use and infertility, adding to a growing body of evidence which can inform professional society recommendations and patient counseling.