Infertility risk rises in women on multiple antiepileptic drugs

For women with epilepsy, the risk of infertility increases with each additional antiepileptic drug (AED), and more than one-third may be unable to conceive, according to research published online Oct. 11, 2010 in Neurology, HealthDay News reported.

Sapna Cheravalloor Sukumaran, MBBS, 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 the women, who were anticipating becoming pregnant.

After a follow-up period of up to 10 years, 38.4% of the cohort had not become pregnant. Infertility occurred in 7.1% of the women who had never been exposed to an AED and rose to 31.8% with exposure to 1 AED. Women on multiple AEDs had an even greater risk of infertility (40.7% with 2 AEDs and 60.3% with 3 or more AEDs). After adjustment, the use of 3 or more AEDS (OR, 17.9; 95% CI 2.14-149.48); older age (OR, 1.32; 95% CI 0.84-2.09); and lower educational level (OR, 2.91; 95% CI 1.82-4.65) were predictors of infertility.

“Our data show that WWE carry significant risk of infertility when they are exposed to polytherapy,” the authors wrote. “Enzyme-inducing AEDs like PB (phenobarbital) have higher risk of infertility than other AEDs.”