Epilepsy ups the risk of infertility in women--study

Epilepsy is a common chronic neurological disorder, occurring in about 50 million people worldwide, and is characterized by recurrent unprovoked seizures.

The seizures are transient signs or symptoms of abnormal, excessive, or synchronous neuronal activity in the brain.

The findings of the study, published in Oct. 12 print issue of the journal ‘Neurology’, suggest that women with epilepsy undergo hormonal changes due to anti-seizures pills that eventually lead to irregular menstrual cycles.

It is known that anti-seizure drugs have the potential to change the balance of reproductive hormones in the body.

Study details and findings
In a bid to assess the possible link between epilepsy and infertility in women, study researchers conducted a trial on 375 women, with an average age of 26, who were followed for a time period of 10 years or till they became pregnant.

Out of these, 62 percent of women became pregnant during the study period, while 38 percent were not able to conceive in a three-year follow-up period.

The rate of infertility among women with epilepsy was more than twice compared with 15 percent infertility rate in the general population, researchers averred.

Women taking three or more anti-seizure drugs for epilepsy were 18 times more likely to have problems in conceiving than those taking no epilepsy drugs.

Furthermore, seven percent of women taking no epilepsy drugs were found infertile, compared to 32 percent of those taking one epilepsy drug, 41 percent of those taking two epilepsy drugs, and 60 percent of those taking three or more epilepsy drugs.

Study author, Sanjeev Thomas from Sree Chitra Tirunal Institute for Medical Sciences and Technology Trivandrum, India, said in a press release, “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."

Drug-dependent epilepsy might lead to infertility
The researchers also noted that the drug phenobarbital was associated with significant risk of infertility, while no such link was evaluated with valproate or other drugs.

Dr. Steven V. Pacia, director of the Comprehensive Epilepsy Center at Lenox Hill Hospital in New York City, said, "Certain antiepileptic medications (AEDs), including phenobarbital, may affect the metabolism of normal hormones in women with epilepsy.

“This effect will be enhanced at higher doses and by the addition of several other AEDS that may be expected in patients with more severe epilepsy.”

"However, patients with more severe epilepsy can be expected to have a higher incidence of cognitive problems, mood disorders and hyposexuality, which may also lead to higher rates of infertility,” he added.