Epilepsy and Fertility

Epilepsy is one of the most common neurological disorders that manifests as recurrent and unprovoked seizures. Individuals living with epilepsy face challenges across different aspects of life including sexual and reproductive health. Reproductive dysfunction involves the dysregulation of key regulatory hormones in the hypothalamic-pituitary-gonadal (HPG) axis which plays a crucial role in fertility. Reproductive hormonal imbalances affect the ability to conceive through the alteration in gonadal functions such as menstrual irregularity and impaired sperm production. Antiseizure medications (ASMs) used to treat epilepsy to prevent seizures are known to modulate neurochemicals that govern the HPG axis. Common ASMs causes reproductive dysfunction in both men and women with epilepsy that results in dysfunctions like sperm abnormalities in men and increased rate of PCOS in women. This chapter summarizes the effects of different ASMs on sexual and reproductive function while also exploring the medical and emotional support available for individuals living with epilepsy, highlighting the importance of balancing seizure control with reproductive goals.