August 10, 2022

Epilepsy and infertility: things to think about when planning a family

Lifestyle & Wellness

If you’d like to start a family, it’s important to be aware of epilepsy and infertility issues. Read about epilepsy drugs, infertility and other topics

If you have a seizure disorder and are thinking about starting a family one day, it's helpful to know about epilepsy and infertility. Many people with epilepsy are perfectly able to conceive, but it may be harder than for others. Here's everything you need to know about epilepsy and infertility.

Woman looking at a pregnancy test

The science around epilepsy and infertility is still unclear

Over the years, researchers have noticed that people with epilepsy seem to have fewer children than those who don't have the condition. It is still unclear exactly why this might be happening. It’s also recognized that some anti-epilepsy drugs (including phenytoin, carbamazepine and phenobarbital) lead to a lower sex drive for both men and women.

That said, there are some contradictory findings. In a 2016 study, women with epilepsy were able to get pregnant just as easily as women who didn’t have seizures. 

Need to know: Sodium valproate and pregnancy risks

Can epilepsy drugs make you infertile?

Not exactly. No epilepsy medication is known to directly cause infertility. They may affect hormones and sex drive, and this means you might be less likely to want to have sex or be able to conceive. On the flipside, some anti epilepsy drugs - particularly lamotrigine and levetiracetam - may in fact help improve semen quality in men with epilepsy.

Researchers have found some possible links between epilepsy drugs and fertility issues. 

Women

One study in India found a link between the number of epilepsy drugs women were taking and their ability to get pregnant. The researchers found that the more epilepsy drugs women were taking, the harder it was for them to become pregnant. This seems to suggest that epilepsy drugs could be part of the problem.

Learn more: Women and epilepsy - the issues

Men

Meanwhile, a study in Finland looked at epilepsy and infertility in men. The results showed that men who were taking certain epilepsy drugs (carbamazepine, oxcarbazepine and valproate) had lower sperm counts than other men. This could make it harder to get their partners pregnant. 

Learn more: Men and epilepsy - the issues

If you are concerned that your epilepsy drugs are making you infertile, do not stop taking them - this could lead to a breakthrough seizure. Instead, speak to your epilepsy specialist about your options for using other kinds of anti-epilepsy drugs or treatment methods.

Other issues around epilepsy and infertility

There are a number of factors that could contribute to fertility problems in people with epilepsy. Figuring out the causes of epilepsy fertility issues can be a ‘chicken or the egg’ situation – knowing which factor came first is very challenging, and varies from one person to the next. 

Possible causes of epilepsy and fertility issues include:

  • The effects of seizures on hormone levels
  • The effects of anti-epilepsy drugs on hormones and sex drive
  • Self-esteem issues that people with epilepsy may experience
  • Mood disorders, including depression or anxiety
  • Social and cultural barriers 
  • Concerns people might have about intimacy – including fear of seizures during sex
  • Other fertility issues not directly related to epilepsy

Pregnancy: Folic acid and pregnancy for women with epilepsy

Family planning with epilepsy

If you have epilepsy and are concerned about infertility, speak to your neurologist and a fertility specialist. They can do tests to understand more about your body and your personal situation. 

The good news is that many fertility problems can be treated, and many people with epilepsy go on to have families just as they would like.