How epilepsy affects male fertility and steps to overcome the challenge

Hyderabad: Epilepsy, also known as brain seizures, is a chronic neurological disorder that causes recurrent seizures due to sudden abnormal electrical activity in the brain. These seizures can result in brief lapses in awareness to intense physical convulsions.

The effects of epilepsy have also been found to be linked to male reproductive capability, although not directly.

People may develop epilepsy due to brain injury, stroke, tumours or genetic factors, but in most cases, the cause remains unknown.

Epilepsy affects approximately 650 million people worldwide, with 80 per cent of cases from developing countries. In these regions, the incidence rate of new epilepsy cases is between 40 to 70 per 100,000 individuals annually.

The International Epilepsy Day is observed on the second Monday of February every year, with the theme in 2025 being ‘My Epilepsy Journey.’

Impact on male fertility

An important impact of epilepsy is the effect on the reproductive health of men. Even though there is no direct link between epilepsy and infertility, experts opine that conditions of seizures and medications used can affect male reproductive health.

Dr Raghuveer Karne, consultant andrologist, Oasis Fertility Hospitals, Hyderabad said, “Epilepsy is not just a neurological condition as it affects a person’s overall health, particularly their reproductive health. In men, it has a strong impact on male fertility.”

While there is no direct link between epilepsy and male infertility, various healthcare professionals and experts claim that both the condition of seizures and the medications used to treat it can affect a man’s ability to conceive.

Hormone imbalances and sexual dysfunction

Individuals with epilepsy may experience changes in sexual dysfunction, sperm quality and hormonal imbalances. Therefore, it’s critical to comprehend how male fertility is affected by epilepsy and what scientific treatments are available to address these issues.

“Epilepsy affects hormonal balance which causes disruptions in testosterone levels and other reproductive hormones that are essential to produce sperm. Furthermore, Anti-Seizure Drugs (AEDs) especially enzyme-inducing drugs and other medications like Valproate (VPA) can affect sperm quality and count by lowering testosterone levels. This can result in abnormal sperm morphology, decreased motility and lower testosterone levels,” Dr Raghuveer Karne said.

Reduced fertility can also be attributed to various factors beyond medical conditions, including stress, disrupted sleep patterns, and modern lifestyle changes. Men with epilepsy face challenges in sexual health such as erectile dysfunction or decreased sex drive, which can significantly affect their ability to conceive. These difficulties intensify the complexity of managing life with epilepsy.

Seeking aid from fertility specialists or doctors to seek aid for better management and possible fertility preservation strategies can help in overcoming the challenge. However, not all men with epilepsy will have fertility issues.

Dr Raghuveer Karne listed some tips to boost fertility in men suffering from epilepsy:

Consult a fertility specialist or doctor: For someone suffering from epilepsy and who intends to become a parent, it is important to consult a medical expert who specialises in both epilepsy and reproductive health. This allows discussion on the potential issues and management options.

Medication review: Ask the doctor about whether it would be appropriate to switch to an AED that has less of an effect on fertility.

Semen analysis: Ongoing semen analysis can help to track the quality of sperm and spot any possible drug or epilepsy-related problems.

Sexual Dysfunction: Erectile dysfunction, ejaculation issues and decreased libido are some of the sexual dysfunctions that epilepsy can cause. Naturally, these problems can make getting pregnant more challenging.

“A change in lifestyle would be essential since stress, anxiety and depression can have a detrimental effect on hormone levels and sexual function in men with epilepsy. Fertility can also be further hampered by certain lifestyle choices linked to epilepsy such as smoking or binge drinking. The help of Assisted Reproductive Technologies (ART) like in vitro fertilisation (IVF) can be considered for severe fertility issues,” Dr Raghuveer Karne said.