Epilepsy and Infertility




Epilepsy affects about one per cent of the population world over and almost half of them are women. There are certain special concerns about epilepsy in women, including effects on ovarian dysfunction; sexual dysfunction; contraception; pregnancy; and breast feeding.The most common ovarian problem in women is polycystic ovarian syndrome (PCOS). This problem is prevalent in about 5-6 per cent of women in the general population. But in women with epilepsy the prevalence is 10-20 per cent.

This is due to non-maturation of ovarian follicles owing to hormonal imbalance. In WWE, certain anti-epileptic medication can contribute to PCOS. The treating physician should offer tailor-made medication in women who are in the reproductive age group. Fertility is another issue, again due to hormonal imbalance. Fertility rate of women with epilepsy is one third of the general population. The anti-epileptic drugs may also result in contraceptive failure in women who are on oral contraception.

Also, the risk of malformations in a child whose mother is on anti-epileptic drugs is 2 to 3 times higher than that in general population. The risk is higher with certain drugs and increases with multiple drugs, if used during pregnancy, he said.

However, breastfeeding should be encouraged in women with epilepsy. The issues in school-going children are different and they need to be addressed carefully. The primary concern is to control epilepsy. But, this should not be at the expense of scholastic compromise, quality of life issues and sports or leisure pursuits. If such problems arise while on treatment, the treating doctor should find out whether the problem is due to the effect of the drugs or a co-morbidity.




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Directorate of Social Welfare.
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