Effects of Antiepileptic Drugs on Sperm Motility of Normal Controls and Epileptic Patients with Long‐Term Therapy

Abstract

The in vitro effects of four antiepileptic drugs (AEDs) on human sperm motility were studied with a transmembrane migration method. Sperm motility of epileptic patients receiving chronic AED therapy was also investigated. Sperm motility was measured immediately after semen had been mixed with AED and after a 2-h preincubation at 37 degrees C. Both in vitro and in vivo studies demonstrated that AEDs inhibited sperm motility. When the drug effect was evaluated after the semen-AED mixture had been preincubated for 2 h, sperm motility was inhibited to 50% of control at concentrations of 1.59, 4.23, and 5.00 mM for phenytoin, carbamazepine, and valproate, respectively. Both with and without preincubation, phenobarbital, even up to 12.92 mM, did not inhibit the motility to less than 50% of the control. In the in vivo study, poor sperm motility was noted in epileptic patients with long-term AED therapy despite serum levels within the therapeutic range. Shorter duration of activity of spermatozoa was also observed in these patients. Interference with sperm membrane function by AEDs may be the underlying mechanism.

Treatment Effects Of Onion (Allium cepa) And Ginger (Zingiber officinale) On Sexual Behavior Of Rat After Inducing An Antiepileptic Drug (lamotrigine)

“…It was realized that using Lamotrigine does not cause changes in hormone level and does not change the sexual function. This study advises the users of the valproate sodium to use Lamotrigine in generalized idiopathic convulsion in the case of disorder in sexual function (27,28). The results of the study concerning the reduction of testosterone hormone is incompatible with our study, however the results of the study showed that hormone level in Lamotrigine group in proportion to the control group has been reduced meaningfully.…”

Male Infertility: Possible Association with Valproate Exposure

“…Within 2 months after discontinuation of VPA, a complete reversal of the spermatic dysfunction and a successful conception make it appear that VPA in this individual was responsible for spermatic dysfunction. There is in vitro evidence that AEDs can adversely affect spermatic motility (6). We suggest that practitioners with VPA-treated male patients with infertility have their spermatic function evaluated.…”

“…Social and biologic influences affecting fertility in both men and women with epilepsy were studied by Schupf and Ottman (3, but relatively little attention has been paid to the issues of infertility in men with epilepsy. Chen et al (6) studied the in vitro effect of antiepileptic drugs (AEDs) on human spermatic motility. They demonstrated marked inhibition of motility with exposure to phenytoin (PHT), carbamazepine (CBZ), and VPA.…”

Sex Hormones, Gonadotropins and Prolactin in Male Epileptic Subjects in Remission: Role of the Epileptic Syndrome and of Antiepileptic Drugs

“…A decrease in reproductive function [41] and poor sperm motility [42] have been observed in treated epilep tics. Baseline and stimulated FSH levels were found by us to be increased in some epileptic patients, independent of their age, disease type and treatment.…”