Abstracts

Rationale: There is much concern, whether epilepsy or antiepileptic drug therapy (AED) is associated with infertility in Women with Epilepsy (WWE). We analysed the fertility pattern in WWE enrolled in the preconception stage in the Kerala Registry of Epilepsy and Pregnancy (KREP). Methods: We stratified registrants in pre-pregnancy stage with at least one year follow up in to those who subsequently conceived (fertility group - FG) or those who failed to conceive (infertility group - IG) until the last date of follow up. The demographic and epilepsy characteristics, AED therapy and seizure frequency were compared between the two groups. Results: Between 1998 and 2008, there were 386 registrations in preconception stage (FG = 190 and IG = 196) FG had lower age (24.8 + 3.5 years) and shorter period of married life (479 + 739 days) than IG (26.3 + 4.9 years and 991 + 1474 days respectively). AEDs used (monotherapy) were, carbamazepine 249 (75), valproate 214 (75). Phenytoin 91 (20), phenobarbitone 86 (17) others 107 (8).Infertility expressed as percentage according to the number of AEDs exposed was for no AED exposure (n=10) 0%, 1 AED (n=195) 32.8%, 2 AEDs (n=82) 57.3%, 3 AEDs (n=42) 81%, 4 AEDs (n=17) 94.1%.On logistic regression, there was no association between infertility and any particular AED although most AEDs showed significant association on direct comparison. Conclusions: WWE had higher prevalence of infertility. The risk of infertility progressively increased as the number of AEDs increased.