Psilocybin Mushrooms and Fertility
Direct Answer
There is no evidence that psilocybin mushrooms have any effect on fertility in either men or women. The provided clinical guidelines and research literature contain no data linking psilocybin use to reproductive dysfunction, sperm parameters, ovarian function, or fertility outcomes.
Evidence Analysis
What the Guidelines Actually Address
The comprehensive fertility preservation guidelines from ESMO, AUA/ASRM, and ASCO extensively catalog substances and treatments that affect fertility, including 1:
- Chemotherapy agents (alkylating agents, platinum compounds, anthracyclines)
- Radiation therapy (doses as low as 0.1 Gy affecting spermatogenesis, 2 Gy affecting ovarian follicles)
- Targeted therapies (monoclonal antibodies, small molecules - mostly unknown risk)
- Immunotherapy (unknown risk)
- Anabolic steroids (suppress spermatogenesis) 1
- Lifestyle factors with limited evidence (smoking, obesity, heat exposure) 1
Psilocybin is conspicuously absent from all fertility risk stratification tables and discussions 1.
What We Know About Psilocybin
The available research on psilocybin focuses on 2, 3, 4, 5:
- Pharmacology: Psilocybin is metabolized to psilocin, which acts as a serotonin 2A receptor agonist
- Safety profile: Emergency medical treatment seeking occurs in only 0.2% of users, with most adverse effects being psychological (anxiety, paranoia) and resolving within 24 hours 2
- Mechanism: Effects are mediated through 5-HT2AR occupancy in the brain 5
None of these studies examine or report reproductive toxicity, gonadal function, or fertility outcomes 2, 3, 4, 5.
Clinical Implications
For Male Fertility
The WHO and AUA guidelines emphasize that male infertility counseling should address 1:
- Known gonadotoxic medications (cyclophosphamide, anabolic steroids)
- Lifestyle factors with documented but limited evidence (smoking, obesity)
- Occupational exposures and endocrine-disrupting chemicals
Psilocybin does not appear in any category of reproductive risk 1.
For Female Fertility
ESMO guidelines detail that ovarian toxicity occurs with 1:
- Alkylating agents (causing primordial follicle depletion)
- Radiation (follicle loss at doses <2 Gy)
- Some targeted agents (bevacizumab has uncertain risk)
Psilocybin is not mentioned as having any impact on ovarian reserve, follicle development, or hormonal function 1.
Important Caveats
- Absence of evidence is not evidence of absence: The lack of data on psilocybin and fertility reflects limited research rather than proven safety 1
- Recreational drug use context: Guidelines acknowledge that data on most lifestyle and environmental factors affecting fertility remain limited and require further study 1
- Substance mixing: The most common reason for adverse psilocybin reactions involves mixing with other substances, which could theoretically include fertility-affecting drugs 2
Bottom Line
Based on the complete absence of psilocybin from comprehensive, high-quality fertility preservation guidelines (ESMO 2020, AUA/ASRM 2021, ASCO 2006) and the lack of any reproductive toxicity data in the pharmacological literature, there is no established link between psilocybin mushroom use and impaired fertility 1. If psilocybin posed a clinically significant fertility risk, it would be expected to appear in at least one of these exhaustive guideline documents that catalog even agents with "unknown risk" 1.