Abstracts

RATIONALE:Low fertility has been reported in men with epilepsy, and this has been attributed to the use of antiepileptic drugs (AEDs). Furthermore, animal studies have suggested that valproate (VPA) treatment may be associated with testicular atrophy in rats and dogs. The aim of the present study was to evaluate semen quality and testicular volume in men taking carbamazepine (CBZ), oxcarbazepine (OXC), or VPA monotherapy for epilepsy. METHODS:_Semen quality (sperm count, morphology, and motility) was assessed, and ultrasonography of the testicles was performed in 48 men with epilepsy and in 35 healthy control men of similar age. 13 of the men with epilepsy were taking CBZ, 14 OXC, and 21 VPA. RESULTS:_Abnormally low sperm count was more common among CBZ (31 %, p<0.001) or OXC (14 %, p<0.05) treated men than among control men (0 %), whereas men taking VPA for epilepsy had reduced sperm motility (p<0.05). High frequency of abnormal spermatozoa was found in all treatment groups (CBZ: 31 %, p<0.01; OXC: 21 %, p <0.05; VPA: 29 %, p<0.01, compared with the control subjects: 3 %). The mean sum volume of the testicles was smaller in men on VPA (63.4 13.2 cm3) than in the control men (80.8 23.0 cm3) (p<0.05), but it was normal in men on CBZ or OXC. CONCLUSIONS:The results of the present study suggest that CBZ, OXC, and VPA may affect semen quality in men with epilepsy. In addition, VPA medication may be associated with reduced testicular volume. However, further studies are needed to evaluate the effects of epilepsy itself and AEDs on testicular structure and function.