Infertility secondary to valproate |
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| Institution: | 1. Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bengaluru 560029, India;2. Centre for Addiction Medicine, Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bengaluru 560029, India;1. Department of Nursing, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75390-8855, United States of America;2. University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75390-8855, United States of America;1. From the Department of Medicine, University of California, San Diego, La Jolla, California;2. the Department of Endocrinology, Wuhan Red Cross Hospital, Wuhan, Hubei, China;3. the Department of Health Sciences, Victor Valley College, Victorville, California;4. the Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China. |
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| Abstract: | Valproic acid (VPA) is generally thought to be more benign in terms of fertility effects in patients with epilepsy than carbamazepine (CBZ) or phenytoin (PHT) due to its lack of liver-enzyme-inducing properties. We report a patient treated with VPA for partial seizures, previously fertile on CBZ. When conception failed while taking VPA, semen analysis revealed a decreased number of sperm, reduced motility, and altered morphology. Endocrinologic studies and evaluation of the patient's wife were all normal. Successful pregnancy was achieved and abnormal sperm indices reverted to normal when VPA was discontinued and CBZ reinstituted. It is probable that a direct gonadal or sperm membrane effect of VPA is the responsible mechanism for this rare phenomenon. |
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