Abstract
Studies suggest that women with epilepsy (WWE) have reduced fertility rates when compared to the general population. Wallace and colleagues,1 using the General Practice Research Database in the United Kingdom, reported that fertility rates among women with epilepsy were 33% lower than in women in the general population. Not all studies have demonstrated such findings, however. In their population-based study in Iceland, Olafsson and colleagues2 found no evidence of reduced fertility in WWE. All previously published studies assessing fertility rates in WWE are retrospective. Potential contributing factors to reduced fertility in WWE include lower marriage rates, reproductive endocrine dysfunction secondary to antiepileptic (AED) drug exposure and seizure type, fear of malformations secondary to AED exposure, concern of increased risk of epilepsy in offspring, and social stigmatization of epilepsy.1,3 AEDs may influence fertility. Enzyme-inducing AEDs are known to affect concentrations of sex steroid hormones and sex hormone binding globulin. Reduced sex steroid hormones and elevated sex hormone binding globulin together reduce the bioavailability of reproductive …
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