Reproduction among individuals with idiopathic/cryptogenic epilepsy: risk factors for reduced fertility in marriage

Abstract

Purpose: We wished to determine risk factors for reduced fertility in marriage in men and women with idiopathic/cryptogenic epilepsy and to relate rates of reproduction to the risk of epilepsy in offspring of affected individuals.

Methods: We determined history of pregnancy and child bearing among 863 adults with idiopathic/cryptogenic epilepsy (ascertained from voluntary organizations) who had been married at some time in their lives and from their same-sex siblings without epilepsy who had been married. We examined the effects of seizure type, age at onset, and family history of epilepsy on fertility. Fertility rates were measured as live births per person-year of marriage before and after onset of epilepsy and compared with fertility rates among same-sex siblings without epilepsy by incidence rate ratios (IRR).

Results: For both men and women with epilepsy, reduced fertility was observed after, but not before, onset of epilepsy. Among both men and women with epilepsy, those with partial onset and early age at onset (< 10 years) were more reproductively disadvantaged than those with generalized onset and later age at onset. Among those with epilepsy, men with a family history of epilepsy were less reproductively disadvantaged than men without a family history of epilepsy, whereas women with and without a family history of epilepsy did not differ.

Conclusions: We found no evidence of selectively reduced fertility among men with a genetic susceptibility to epilepsy that could account for the higher risk of epilepsy among offspring of affected women than among offspring of affected men.