EEC 2026 | Reproductive health in males with epilepsy: the impact of antiseizure medications

Epilepsy is associated with reduction in reproduction. So persons with epilepsy have fewer children than those without. So there’s a clear impact on reproduction. But reproduction is a complex issue, so it includes both biological and societal factors. So social isolation will, of course, lead to reduced reproduction. But there will also be more biological factors from medication. And some of the drugs associated with an impact on hormone production. It could be something like carbamazepine, which could influence the levels of testosterone in males. And in other drugs, for example, valproate in animal studies suggests that there’s a reduction in fertility secondary to the use of valproate. And then most recently, there has been some concern from the European Medicines Agency about the risk in the offspring after paternal use of valproate during the time of conception. Yeah, so right now this concern has been raised. It’s been questioned by several investigators, including us. So we’re a little bit uncertain how solid this information is, but the warning is out there and I think we need to convey this information to our patients so that they can take the decision themselves. What we know from all of the studies is that the absolute risk is low so it’s much much lower than the risk associated with valproate exposure in mothers so I think that that’s important that there’s this different exposure but as of now the warning is out there so we need to convey that to our patients in a balanced way. So possibly a slightly increased risk.

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