Effects of Valproate (VPA) and Carbamazepine (CBZ) on Testicular Size and Semen Quality in Male Epileptic Patients.
Abstract number :
2.068
Submission category :
Year :
2000
Submission ID :
2451
Source :
www.aesnet.org
Presentation date :
12/2/2000 12:00:00 AM
Published date :
Dec 1, 2000, 06:00 AM
Authors :
Leif Gjerstad, Erik Tauboll, Trine B Haugen, Line Sveberg Roste, Tone Bjornenak, Erik Saetre, Per Olav Dale, Rikshospitalet, Oslo, Norway; Rikshospitalet, Univ of Oslo, Oslo, Norway; Ullevaal Hosp, Univ of Oslo, Oslo, Norway.
RATIONALE: It has recently been shown that long-term VPA treatment induces testicular atrophy and reduced spermatogenesis in rats and dogs. We therefore intended to study the effects of chronic VPA or CBZ treatment on testicular size and semen quality in male epileptic patients and to compare the results with those of non-epileptic fertile males. METHODS: Twenty-one male epilepsy patients on either VPA (n=8) or CBZ (n=13) monotherapy for at least 2 years were recruited from an out-patient clinic. A medical examination, evaluation of testicular size with orchidometry and semen analyses were performed. Semen samples were analysed according to WHO laboratory manual for examination of human semen and sperm-cervical mucus interaction (1999). The time for sexual abstinence was at least three days, and the sample volume, sperm concentration, motility and vitality were assessed. RESULTS: The proportion of generalized versus partial epilepsy were 7 to 1 in the VPA, and 6 to 7 in the CBZ treated group. Mean age was 27.9 and 32.6 in the VPA and CBZ treated groups, while time on current medication was 10.0 and 12.4 years, respectively. There was a significantly higher body mass index in VPA treated (mean 33.2, p<0.03, t-test) compared to CBZ treated patients (mean=25.3). Testicular size was equal between the two treatment groups with a mean testicular volume of 18.4 ml in both VPA and CBZ treated males. There was a slight, but non-significant, lower semen volume of 3.64 ml and lower total sperm count of 227x106/ml in the VPA group compared to 4.19 ml and 303x106/ml in the CBZ treated patients. No differences were observed in the other measured variables. The results from the group of epilepsy patients, either taken together or split according to medication, did not differ significantly from that of a population of fertile males investigated in the same laboratory. CONCLUSIONS: Neither VPA nor CBZ reduced testicular size after chronic treatment. Semen analyses did, however, reveal a non-significant trend towards reduced semen volume and total sperm count after VPA treatment, a finding that should be explored further in a larger patient group.