Rate of Infertility Higher in Women with Epilepsy
Both epilepsy and epilepsy treatments affect fertility and reproduction, confirms a new study from the Sree Chitra Tirunal Institute for Medical Sciences and Technology in India. Women with epilepsy were found to have twice the infertility rate of the general population, and that increased for those taking anti-epilepsy drugs.
Women with Epilepsy Had More than Twice the Infertility Rate of the General Population
Study author Sanjeev Thomas and colleagues studied 375 women with epilepsy, average age 26, who planned to have a child. During the 10-year study period, 62% became pregnant, usually within 2 years of trying to conceive.
Overall, women with epilepsy had more than twice the 15% rate of infertility found in the general population. For those taking three or more drugs to control symptoms, women were 18 times more likely to have reproduction problems than those taking no drugs. Phenobarbital was the most commonly associated drug with the increased risk, as it affects the metabolism of normal hormones.
Older women and women with less than 10 years of education were also more likely to experience infertility.
"This may be due to the adverse effects of taking multiple drugs or it could be a more indirect effect because people who are taking multiple drugs are more likely to have severe epilepsy that is difficult to treat," said Thomas in a news release from the American Academy of Neurology.
Women with epilepsy may have hormonal changes associated with seizures that contribute to irregular menstrual cycles, says epilepsy.com. Polycystic ovary syndrome, for example, is a common condition among epileptic women, particularly those taking valproic acid.
Women with severe epilepsy also have a higher incidence of cognitive problems, mood disorders and hyposexuality that lead to higher rates of infertility, says Dr. Steven V. Pacia, director of the Comprehensive Epilepsy Center in New York City.
"Based on these findings, women with epilepsy should be counseled about the potential risk of infertility and referred for an evaluation if they have not conceived within two years" of trying to become pregnant, said Dr. Alison M. Pack, a neurologist at Columbia University in New York City, who wrote an accompanying editorial in the journal.