Abstracts

Rationale: The purpose of this research is to determine if a relationship exists between paternal anti-epileptic drugs (AEDs) use and offspring conception time. It has long been established that men with epilepsy are far less likely to father children than men without epilepsy.¹ However, more recently, AEDs, specifically valproate, have been shown to reduce sperm motility, alter morphology, and decrease overall count.² Furthermore, enzyme-inducing AEDs such as carbamazepine and phenytoin have been shown to decrease biologically available testosterone.³ Together, these studies suggest a relationship between AED use and male fertility. However, no studies to date have focused on the length of time necessary for offspring conception for fathers who are using AEDs during attempted conception, despite this being a frequent concern of male patients using AEDs.Beyond conception times, teratogenicity and adverse neurodevelopmental outcomes in the children of epileptic women using AEDs have been well-studied and correlated to in utero AED use.^{4, 5} For example, Alsdorf and Wyszynski have demonstrated the association between in utero valproate exposure and various neurodevelopmental and congenital malformations such as a 20-fold increase in neural tube defects, developmental delays, cleft lip, and cardiovascular abnormalities.⁶ Despite the numerous studies conducted in women, scarce data exist in men.⁷ This study further set out to collect data regarding offspring neurodevelopmental outcomes in this population. Methods: This is a retrospective, questionnaire-based study involving male participants over eighteen who obtain care at the Mount Sinai Neurology Clinic. The experimental group consists of patients previously diagnosed with epilepsy and on AEDs at the time of conception. The control group contains patients receiving care for other neurological conditions. Descriptive data analyses were completed. Results: To date, data has been collected for 14 babies born to fathers taking AEDs at the time of conception versus 128 controls. Currently, no statistically significant differences have been observed between experimental and control groups regarding the length of time for offspring conception. Conclusions: Initial data does not indicate an association between paternal AED use during conception and an increased time period for offspring conception, though more data will be collected to confirm this.References:1.            Webber MP, Hauser WA, Ottman R, Annegers JF. Fertility in persons with epilepsy: 1935-1974. Epilepsia. 1986;27:746-752.2.            Hamed SA, Moussa EM, Tohamy AM, et al. Seminal fluid analysis and testicular volume in adults with epilepsy receiving valproate. Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia. 2015;22:508-512.3.            Blume WT. Low fertility in men with epilepsy: unhappy, uninterested, unable. Epilepsy Currents. 2009;9:69-70.4.            Harden CL, Meador KJ, Pennell PB, et al. Management issues for women with epilepsy- Focus on pregnancy (an evidence-based review): II. Teratogenesis and perinatal outcomes: Report of the Quality Standards Subcommittee and Therapeutics and Technology Subcommittee of the American Academy of Neurology and the American Epilepsy Society. Epilepsia. 2009;50:1237-1246.5.            Velez-Ruiz NJ, Meador KJ. Neurodevelopmental effects of fetal antiepileptic drug exposure. Drug Safety. 2015;38:271-278.6.            Alsdorf R, Wyszynski DF. Teratogenicity of sodium valproate. Expert Opinion on Drug Safety. 2005;4:345-353.7.            Annegers JF, Hauser WA, Elveback LR, Anderson VE, Kurland LI. Congenital malformations and seizure disorders in the offspring of parents with epilepsy. International Journal of Epidemiology. 1978;7:241-247. Funding: None