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Anti-epileptic medication "can affect men's fertility"

19 February, 2004

Two new reports have suggested that men with epilepsy, who often have
fertility problems, may find these problems worsened due to their anti-epileptic
drugs.

One team, from the University
of Oulu
in Finland, suggest that if fertility
problems are encountered by a man with epilepsy then analysis of the
semen should be conducted. However, measuring hormone levels in individual
men is of little use according to a study from the University
of Bonn
.

The team from Bonn, led by Dr Jurgen Bauer, studied 200 men with epilepsy
who were taking no more than one anti-epileptic drug and compared the
results to a study of 105 other men without epilepsy.

While total testosterone
levels were similar in the two groups, levels of "free" testosterone
were lower in the group of men with epilepsy, and levels of both types
of testosterone were lower in men
with temporal lobe epilepsy than in other types of the condition. In
addition, levels of testosterone in men taking the anti-epileptic drug
carbamazepine were "significantly lower" than in men taking
valproate.

The researchers wrote:

"Carbamazepine may therefore
have the potential to aggravate the negative effects of temporal lobe
epilepsy on testicular testosterone
production."

Meanwhile, the Finnish group studied the reproductive health of 60 men
with epilepsy taking the anti-epileptic drugs valproate, carbamazepine
or oxcarbazepine and a group of 41 men who didn't have epilepsy. They
found that abnormal sperm was more often found in the men with epilepsy.

Lead researcher Dr Jouko Isojarvi wrote:

"Carbamazepine or partial
epilepsy may affect sperm concentration, morphology, and motility.
Valproate or generalized epilepsy may be associated
with a high number of spermatozoa with abnormal morphology and motility,
and oxcarbazepine may be associated with abnormal morphology of sperm."

Valproate was also linked to reduced testicular volume, which was associated
with abnormal sperm but not with serum hormone levels.