Abstract
BackgroundAntiepileptic drugs are responsible for reproductive dysfunction in male epileptic patients.ObjectivesTo evaluate the effect of valproate (VPA) versus levetiracetam (LEV) as a monotherapy on males’ sex hormones and sperm parameters in newly diagnosed epileptic patients.Materials and methodsThis comparative study included 50 newly diagnosed epileptic male patients. All patients were subjected to complete general and neurological examination, Doppler ultrasonography of the testis, pre- and post-treatment serum sex hormone assay, and semen analysis. Post-treatment re-evaluation checkpoint was determined if 8 weeks have passed after the last seizures. This study included two groups, group I (25 patients were treated by VPA) and group II (25 patients were treated by LEV).ResultsThere was no statistical difference between groups regarding their baseline characteristics. In group I, at post-treatment checkpoint, we found significant decrease in luteinizing hormone and follicle-stimulating hormones and highly significant increase of prolactin serum level. In sperm parameters, there was significant decrease of all measured items. In group II, serum sex hormone was not significantly changed at post-treatment checkpoint but semen analysis parameters were significantly decreased regarding all items. In comparison between the two groups, there was significant decrease of sperm concentration among group II with highly significant decrease of normal morphology of sperm among group I.ConclusionBoth VPA and LEV had adverse effects on the semen of male epileptic patients while VPA had also an adverse effect on sex hormones.
Highlights
Antiepileptic drugs are responsible for reproductive dysfunction in male epileptic patients
In group I, at post-treatment checkpoint, we found significant decrease in luteinizing hormone and follicle-stimulating hormones and highly significant increase of prolactin serum level
Patients were subclassified into two groups who were matched in age, group I (25 patients) was treated by valproate (VPA) as an initial monotherapy for seizures
Summary
Antiepileptic drugs are responsible for reproductive dysfunction in male epileptic patients. Epilepsy is a chronic neurological disorder characterized by recurrent epileptic attacks, and researches have reported that the relationship between epilepsy and the reproductive dysfunction is not yet completely understood [1]. Seizures are linked with sexual dysfunction as part of the disease pathophysiology in these patients [2]. The hypothalamus receives signals from the hippocampus, amygdala, and cerebral cortex. The available antiepileptic drugs (AED) have not yet been proven to have negative impacts on sexual function. Evaluation of AED-induced sexual dysfunction is complicated, less than clear, and is hard to find. Sex hormone levels can be changed due to AEDs which are the cause of sexual dysfunction and reproductive disorders [4]
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