Effects of carbamazepine on semen parameters in men with newly diagnosed epilepsy

  • Ali Asadi-Pooya Mail Department of Neurology, School Medicine, Shiraz University of Medical Sciences, Shiraz, Iran AND Department of Neurology, Sidney Kimmel Medical College AND Jefferson Comprehensive Epilepsy Center, Thomas Jefferson University, Philadelphia, PA
  • Mohsen Farazdaghi Department of Neurology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
  • Nahid Ashjazadeh Department of Neurology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
Keywords:
Carbamazepine, Epilepsy, Semen, Men

Abstract

Background: We investigated the effects of carbamazepine (CBZ) on semen parameters in men with newly diagnosed epilepsy, by performing semen analysis before starting any antiepileptic drugs, and then after starting CBZ, to determine the role and effects of CBZ in creating abnormalities in sperm analysis in these patients.
Methods: In this prospective study, eight male patients 20-40 years of age who were referred to the outpatient epilepsy clinic at Shiraz University of Medical Sciences, Iran, from 2009 to 2012, due to new-onset seizure(s) were studied. A semen analysis was performed. CBZ was started and after at least 3 months of taking CBZ, another semen analysis was requested to determine the changes in semen quality. Statistical analyses were performed using non-parametric Wilcoxon test.
Results: Mean age of the patients was 28.5 ± 3.5 years. 7 (87.5%) patients had temporal lobe epilepsy and 1 (12.5%) had parietal lobe epilepsy. The mean follow-up period was 5.5 ± 0.9 months. We observed that semen quality (concentration, progressive motility, morphology) has significantly changed in patients with newly-diagnosed epilepsy after being treated with CBZ (P = 0.012 for all indices).
Conclusion: This study shows the direct effects of CBZ in causing changes in semen quality in men with epilepsy. Abnormalities in sperm concentration, morphology and motility, which were observed in the current study, might play a significant role in causing reduced fertility in men with epilepsy.

References

1. Chen SS, Shen MR, Chen TJ, Lai SL. Effects of antiepileptic drugs on sperm motility of normal controls and epileptic patients with long-term therapy. Epilepsia 1992; 33(1): 149-53.
2. Gates JR. Epilepsy versus antiepileptic drugs and gonadal function in men. Neurology 2004; 62(2): 174-5.
3. Curtis VL, Oelberg DG, Willmore LJ.Infertility secondary to valproate. Journal of Epilepsy 1994; 7(4): 259-61.
4. Sveberg RL, Tauboll E, Berner A, Berg KA, Aleksandersen M, Gjerstad L. Morphological changes in the testis after long-term valproate treatment in male Wistar rats. Seizure 2001; 10(8): 559-65.
5. Yerby MS, McCoy GB. Male infertility: possible association with valproate exposure. Epilepsia 1999; 40(4): 520-1.
6. Soliman GA, Abla A, el M. Effects of antiepileptic drugs carbamazepine and sodium valproate on fertility of male rats. Dtsch Tierarztl Wochenschr 1999; 106(3):110-3.
7. Roste LS, Tauboll E, Haugen TB, Bjornenak T, Saetre ER, Gjerstad L. Alterations in semen parameters in men with epilepsy treated with valproate or carbamazepine monotherapy. Eur J Neurol 2003; 10(5): 501-6.
8. Reis RM, de Angelo AG, Sakamoto AC, Ferriani RA, Lara LA. Altered sexual and reproductive functions in epileptic men taking carbamazepine. J Sex Med 2013; 10(2): 493-9.
9. Herzog AG. Disorders of reproduction in patients with epilepsy: primary neurological mechanisms. Seizure 2008; 17(2): 101-10.
10. Verrotti A, Loiacono G, Laus M, Coppola G, Chiarelli F, Tiboni GM. Hormonal and reproductive disturbances in epileptic male patients: emerging issues. Reprod Toxicol 2011; 31(4): 519-27.
Published
2015-10-14
How to Cite
1.
Asadi-Pooya A, Farazdaghi M, Ashjazadeh N. Effects of carbamazepine on semen parameters in men with newly diagnosed epilepsy. Curr J Neurol. 14(3):168-170.
Section
Special Articles