More Than One-Third of Women With Epilepsy Infertile

Antiepileptic drug polytherapy associated with higher risk than monotherapy
By Lindsey Marcellin
HealthDay Reporter

MONDAY, Oct. 11 (HealthDay News) -- For women with epilepsy, the risk of infertility increases with each additional antiepileptic drug (AED), and more than a third may be unable to conceive, according to research published online Oct. 11 in Neurology.

Sapna Cheravalloor Sukumaran, M.B.B.S., of the Sree Chitra Tirunal Institute for Medical Sciences and Technology in Trivandrum, India, and colleagues conducted a prospective cohort study of 375 women with epilepsy (WWE) enrolled in a registry while in the preconception stage. The purpose of the study was to assess the degree of infertility in these women, who were anticipating becoming pregnant.

After a follow-up period of up to 10 years, 38.4 percent of the cohort had not become pregnant. Infertility occurred in 7.1 percent of the women who had never been exposed to an AED and rose to 31.8 percent with exposure to one AED. Women on multiple AEDs had an even greater risk of infertility (40.7 percent with two AEDs; 60.3 percent with three or more AEDs). After adjustment, use of three or more AEDS (odds ratio, 17.9) older age (OR, 1.32), and lower educational level (OR, 2.91) were predictors of infertility.

"Our data show that WWE carry significant risk of infertility when they are exposed to polytherapy. Enzyme-inducing AEDs like PB (phenobarbital) have higher risk of infertility than other AEDs. Demographic factors such as age and educational status are also important predictors of infertility," write the authors.

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