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24-10-2010 | Gynaecology | Article

Polytherapy for epilepsy linked with infertility


Journal abstract

MedWire News: Women with epilepsy taking three or more antiepileptic drugs (AEDs) are 18 times more likely to be infertile than those not taking any, show study results using Indian data.

In addition to AED exposure, lower education and older age also increased the risk for infertility in women with epilepsy, report Sanjeev Thomas (Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum) and co-workers.

A group of 375 women with epilepsy (mean age 25.8 years) who intended to become pregnant were followed-up for a mean of 997 days, during which time 61.6 percent conceived and 38.4 percent did not.

Exposure to AEDs (versus no exposure) increased the odds for infertility 1.52-fold, while use of three or more AEDs (n = 58) corresponded to a 17.9-fold increase in risk.

"This may be due to the direct adverse effect of polytherapy or the indirect effect of underlying refractory epilepsy that required polytherapy," suggest Thomas et al.

Being 25 years old or older and having 10 or fewer years of education also increased the risk for infertility among the women, by 1.32 and 2.91 times, respectively.

"Based on these findings, women with epilepsy should be counselled about the potential risk for infertility and referred for an evaluation if they have not conceived within 2 years," commented editorialist Alison Pack (Columbia University, New York, USA).

MedWire ( is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

By Sarah Guy