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Male infertility: possible association with valproate exposure.

AbstractPURPOSE:
To describe a potential association between male infertility and valproate (VPA) exposure. VPA has been implicated in the development of polycystic ovarian disease and subsequent menstrual and infertility problems in women with epilepsy. Infertility has been well described in population-based studies of persons with epilepsy. The low marital rates for men with epilepsy have previously been thought to play a major contributing role.
METHODS:
We report a case of a 32-year-old man whose wife and he were able to bear a child before the development of his epilepsy. With VPA monotherapy, the family were unable to conceive despite 4 years of unprotected intercourse. An infertility evaluation of the man revealed a very low sperm count of < 50,000/ml, no motile sperm, < 10% viability, and 100% with abnormal structure. Follicle-stimulating hormone, luteinizing hormone, and testosterone levels were normal.
RESULTS:
Felbamate (FBM) was initiated and VPA discontinued for improved seizure control. Within 4 months, the couple conceived their second child. A seminal analysis revealed a sperm count of > 16 million, 50% motility, 78% viability, and 72% with abnormal structure.
CONCLUSIONS:
One must be cautious in extrapolating from a case report, but these findings strongly suggest a direct effect of VPA on spermatic structure and function.
AuthorsM S Yerby, G B McCoy
JournalEpilepsia (Epilepsia) Vol. 40 Issue 4 Pg. 520-1 (Apr 1999) ISSN: 0013-9580 [Print] United States
PMID10219283 (Publication Type: Case Reports, Journal Article)
Chemical References
  • Anticonvulsants
  • Phenylcarbamates
  • Propylene Glycols
  • Valproic Acid
  • Felbamate
Topics
  • Adult
  • Anticonvulsants (adverse effects, therapeutic use)
  • Drug Therapy, Combination
  • Epilepsy (drug therapy)
  • Felbamate
  • Female
  • Humans
  • Infertility, Male (chemically induced, prevention & control)
  • Male
  • Phenylcarbamates
  • Propylene Glycols (therapeutic use)
  • Sperm Count (drug effects)
  • Valproic Acid (adverse effects, therapeutic use)

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