Fertility: Can a man or woman with epilepsy have a baby?

This is an article from the Safe Pregnancy in Epilepsy patient guide.

Epilepsy does not decrease fertility. But Epilepsy medications can affect fertility.

Epilepsy medications can affect the reproductive system in women. Some medications like valproate can cause PCOD.  Epilepsy medications can cause temporary problems in getting pregnant.

Some epilepsy medications can decrease sperm counts. However, epilepsy medications usually do not decrease fertility of males.

Hello! I am Dr Siddharth Kharkar, a Neurologist in Thane, India and a Neurologist in Mumbai, India. I provide Parkinson’s treatment in India and am an Epilepsy specialist in India. I provide Epilepsy surgery in India at Mumbai & Parkinson’s surgery in India.

Come, let’s learn about this important topic.

I think knowing the facts will relieve your stress!

Can a woman with Epilepsy have a baby?


Certainly and definitely!

A woman with Epilepsy can get pregnant. A woman with Epilepsy can have a baby. Many women with epilepsy have babies every year.

baby, boy, caucasian
Many women with epilepsy have succesful pregnancies.

So no, neither epilepsy nor epilepsy medications decrease fertility in women drastically!

You need to be well informed about pregnancy in epilepsy. Also, there are some extra things to take care of.

These articles cover almost everything you need to know about pregnancy in Epilepsy.

Does Epilepsy affect the reproductive system?


There is some controversy about this topic. But, recent research shows that Epilepsy does not affect fertility.

For example:
A recent US study looked at women who were trying to get pregnant. They studied both women with epilepsy, and women without epilepsy.

Most women became pregnant in less than 1 year. Women with epilepsy were equally likely to become pregnant.

So, what is the controversy?

Older research shows that Epilepsy patients may have trouble getting pregnant. There is a simple reason for the difference between newer and older studies.

Patients in earlier studies were on older medications like Phenobarbital. Older epilepsy medications can decrease fertility (see below).

In some patients, seizure medications / epilepsy medications can decrease fertility.

In summary, Epilepsy itself does not affect fertility. But in some cases, older epilepsy medications decrease fertility. Read more below.

Do epilepsy medications affect fertility in women?

Yes. Some medications can.

Please note that these epilepsy medications decrease fertility. They do not abolish it. Many women get pregnant while taking these medications.

Epilepsy medications decrease fertility in women in 2 different ways:

(1) Valproate:

Valproate is one of the older seizure medications. It can disrupt a female’s reproductive cycle. Valproate may cause a condition called Polycystic Ovarian Disease (PCOD).

PCOD causes irregular cycles. PCOD can prevent the female’s eggs from developing normally. As a result, patients with PCOD find it more difficult to become pregnant.

ovary, utero, uterus
PCOD is a common condition in which there are too many cysts in the ovaries.

(2) “Enzyme Inducing seizure medications”:

The liver gradually inactivates hormones floating in the blood. This gives the hormones some time to act on various body parts.

Some seizure medications are called “Enzyme Inducers“. They can cause your liver to go into overdrive. It starts inactivating hormones rapidly! The hormones include estrogen & progesterone. These sexual hormones are important for becoming pregnant.

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The liver neutralizes many chemicals, including hormones.

These “Enzyme Inducing” medications include:
– Phenobarbital
– Phenytoin
– Carbamazepine
– Oxcarbazepine

Phenobarbital really pushes the liver into overdrive! This decimates hormones. Thus, phenobarbital may produce temporary infertility.

The other medications push the liver less hard. But according to some studies, in some cases these epilepsy medications decrease fertility. In my own practice, I find this to be uncommon.

These medications may also disturb child growth during pregnancy. This problem is called teratogenicity. It is described in another article (see below).

Can a man with Epilepsy have a baby?


Certainly and defintely and quite easily!

A man with Epilepsy can have a baby. Many men with Epilepsy have babies every year. Just like women, there are a few extra things to keep track of.

Does epilepsy or epilepsy medications affect fertility in men?

As explained below, epilepsy medications can decrease sperm count.

But because men produce so much sperm, usually epilepsy medications do not affect fertility in males.

There are very few described cases of epilespy medications causing infertility in males. These cases are temporary. After changing medications, sexual function, sperm count and sperm function all improve.

Does Epilepsy affect sperm count?

Epilepsy may decrease sperm production. But this usually does not affect chances of pregnancy.

Usually, men produce a lot of sperm. Every time a male ejaculates, he releases about 40 million or more sperm!

Sperms urine Spermler idrar 02
Sperms under the microscope

Epilepsy may produce mild hormonal changes in men, like it does in women. This may reduce sperm production and may cause slightly higher abnormal sperms.

But due to the huge number of sperm produced, the net effect is usually insignificant.

Do epilepsy medications affect sperm count?


This effect is more significant.

Both kinds of medications described above can have this effect.

(1) Valproate:

It is unclear how valproate reduces male fertility. It may cause hormonal changes. It may also decrease energy production in the testes (mitochondrial dysfunction).

Males treated with Valproate produce fewer sperm. They can get a low sperm count. They also produce higher numbers of abnormal sperm.

Low sperm count e1620912638256
Some seizure medications can reduce sperm production.

Higher doses of Valproate are more likely to produce male infertility. The problem is less marked at lower doses.

(2) “Enzyme inducing seizure medications”

As listed before, these medications include:
– Phenobarbital
– Phenytoin
– Carbamazepine
– Oxcarbazepine

As explained before, these medications put the liver into overdrive. In males, this causes the liver to decrease testosterone in the blood. This can lead to reduced and less speedy sperms.

This effect is less dramatic than the effect of valproate. In my practice, decreased male fertility due to these medications is uncommon.

Newer epilepsy medications are less likely to affect male fertility.

For example:
Levetiracetam is a newer seizure medication. It does not affect sex hormone levels and decreases sperm count only by 10-20%.

So the chance that levetiracetam and newer epilepsy medications decrease fertility in males is very small.

Can epilepsy medications cause impotence?


Some epilepsy medications may decrease sexual hormones. This may decrease your sexual desire (libido).

This is one obvious way in which epilepsy medications decrease fertility. Decreased sex certainly decreases the chances of you becoming pregnant.

Sexual function is commonly affected in males. Males with epilepsy can have trouble maintaining erections. They may have premature ejaculation.

photo 1614439196722 e1620913332823
Impotence & decreased libido are treatable.

These problems are treatable!

  1. You can be shifted to alternative (newer) seizure medications. Most new epilepsy medications do not decrease fertility.
  2. However, this decision needs to be careful. You can lose control of your epilepsy with a different medication.
  3. Medications such as sildenafil (Viagra) can help cure impotence.
  4. Depression is common in Epilepsy. Depression is very treatable. Sexual dysfunction caused by depression goes away, after depression is treated.


  1. Epilepsy does not drastically reduce chances of pregnancy. In some patients, epilespy medications affect fertility.
  2. Valproate may cause PCOD. PCOD makes decrease fertility.
  3. Phenobarbital may cause problems getting pregnant. It does this by over-driving the liver, which decreases sexual hormones.
  4. Phenytoin, Carbamazepine & Oxcarbazepine can also affect fertility. However, this is less common.
  5. Epilepsy, seizure medications & depression can decrease sexual desire (libido). They may cause impotence & premature ejaculation.
  6. Talk to your doctor if you have difficulty getting pregnant. Options include changing to newer medications or taking other treatments.
  7. Be sure to read the “Safe Pregnancy in Epilepsy Checklist”.

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Caution: This information is not a substitute for professional care. Do not change your medications/treatment without your doctor's permission.
Dr. Siddharth Kharkar

Dr. Siddharth Kharkar

Dr. Siddharth Kharkar has been recognized as one of the best neurologists in Mumbai by Outlook India magazine and India today Magazine. He is a board certified (American Board of Psychiatry & Neurology certified) Neurologist.

Dr. Siddharth Kharkar is a Epilepsy specialist in Mumbai & Parkinson's specialist in Mumbai, Maharashtra, India.

He has trained in the best institutions in India, US and UK including KEM hospital in Mumbai, Johns Hopkins University in Baltimore, University of California at San Francisco (UCSF), USA & Kings College in London.

Call 022-4897-1800

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NeuroPlus Epilepsy & Parkinson's Clinic - Dr. Kharkar IconNeuroPlus Epilepsy & Parkinson's Clinic - Dr. Kharkar

near LIC, Dr Balabhai Nanavati hospital, near LIC, Swami Vivekananda Road, LIC Colony, Vile Parle

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  • Avatar Paras Prabhu ★★★★★ 6 months ago
    Out patient is epileptic from about 10 years and her seizure gotten worse during the past year with the frequency of about 3-4 times a week.So we consulted … More Dr. Kharkar. He tried a few medicines, and within 1.5-2 months now the patient is feeling very well now. There are no seizures for 14 days currently.Dr. tried to keep medicines as minimum as possible. He also tried to keep the cost of the treatment minimum.When some of the medicines started showing side-effects, he was quick to switch the medicines to the better options.Overall I think we are getting a best of the available treatments. We thank you very much Dr. Kharkar.
  • Avatar Dr Shobha Sankhe ★★★★★ a month ago
    Dr Kharkar is gem of a doctor with tremendous patience, empathy, genuine concern for his patients .He guides them very methodically & scientifically … More for their neurological ill healthOur epilepsy patient is extremely happy with his treatment , Patient feels better by just visiting him too!May his selfless service to humanity flourish to reach all the needy patients!!
  • Avatar shrruti khanna ★★★★★ a month ago
    I consulted Dr Sidharth for my sister who has become very hyper and aggressive and we could not understand the issue. Keeping in mind she is someone with … More special needs Dr Sidharth was extremely understanding of the situation and did not put her through unnecessary investigation and avoided a very long stay at the hospital. He was infact more keen on her returning home to her natural environment. We highly appreciate Dr Sidharth for his effort and for looking into the matter with utmost care. It was a very difficult decision for my family to get my sister admitted but we are glad we did it under his care.Thankyou Doc.
  • Avatar Prashant Purohit ★★★★★ a month ago
    my name is prashant purohit. I m become completely bed ridden from last 9 months and was unable to walk. I couldnt find out the cause even after visiting … More many doctors and many hospital in Ahmedabad nd jodhpur.started losing hope. A good friend of mine suggested to visit a neurologist. After searching a lot, I came to know about Dr. Siddharth Kharkar and took his appointment in Nanavati Hospital. He examined and said that he suffered from \u201cPKD(PAROXYSMAL KNESIGENIC DYSKNESIA\u201c. He assured us to reverse this in 5 days time. And indeed this happened. I started recovering miraculously. today I am fully well fit I m walking as normal . Many Many thanks to Dr. Siddharth Kharkhar sir for giving me a new life.
  • Avatar Sanjay Pradhan ★★★★★ 7 months ago
    Dr. Kharkar is truly exceptional. He is extremely knowledgeable. But simultaneously, he is extremely patient and kind - taking the time and care to respond … More to all the questions. It is rare to come across a doctor who is not in a hurry to get on to the next patient, but instead, focuses on the one in front with full attention, expertise and compassion. A great experience.
  • Avatar N N ★★★★★ 11 months ago
    We visited Dr. Kharkhar for treatment regarding my mum - who is a multi-stroke patient and has aphasia. Certain medications were creating complications … More with her condition and Dr. Kharkhar was able to help mitigate the issue. We found him and his approach to be incredibly compassionate, considerate, individualized and patient-friendly. He advice is astute, up-to-date and empathetic. His treatment always comes from a deeply human place and is about seeing how to help the patient and their caregivers feel more at ease. Something that is quite rare and refreshing within the medical community.We feel that he genuinely cares about the patients that he is treating and is always kind and respectful in his communication. Moreover, his admin team is very efficient and prompt and it's a pleasure to deal with them.Would highly recommend Dr Kharkhar himself - though we must say our experience with Nanavati hospital itself has been less than ideal.Hope this helps.
  • Avatar Manish Ranjan ★★★★★ a year ago
    I have been visiting Dr Kharkar for treatment of my father. He is a very friendly doctor. He listens to our concerns with lot of patience. He also explains … More the issue in much greater details. He has really been of great help. My father is much better now.
  • Avatar Pinakin Shah ★★★★★ 9 months ago
    One of the best Dr. Gives complete attention and time to listen to patient's history, issues. Explains various options of treatment with pros and … More cons.
  • Avatar Lawrence Castellino ★★★★★ 11 months ago
    Exceptional experience with an expert,Dr. Kharkar is a knowledge house. It is rare nowadays to find doctors with patience, knowledge, and a flair for … More handling patient’s questions, besides Dr. Kharkar’s bedside manners are exemplary. I am privileged to be treated by such an amazing soul. I have told him and will repeat it here that “I am advancing my move back to India although I am a US Citizen, because I know I am in good hands and will be well taken care of. Thanks Dr. Kharkar for your selfless service!
  • Avatar Hemant Kansara ★★★★★ a year ago
    Great doctor!! Really appreciate.The doctor diagnosed to my sister correctly and start treatment, she has good improvement after taking medicine prescribed … More by doctor as no epilepsy attake. We have good experience with the doctor. Thank you

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