Objective:

The objective of this study was to determine the effect of assisted reproductive technology on seizure control in women with epilepsy. 

Background:

Information available about seizure control in women with epilepsy undergoing assisted reproductive technology is sparse, limited to only a few case reports. Extrapolations are often made from situations that similarly heighten the oestrogen-progesterone ratio. 

Design/Methods:

From a database of 3858 women who underwent in vitro fertilization (IVF) or frozen embryo transfer (FET) from January 1992- May 2021, 12 women with epilepsy were identified. Data was obtained through retrospective chart review. 

Results:

From the 12 women identified, the median age of epilepsy onset was 20 years of age (range 25 - 42) with 6 (50%) having epilepsy onset in childhood. There were 26 embryo transfers, resulting in 14 pregnancies and 8 live births.  Nine women (75%) were seizure free for >2 years prior to infertility treatment. Seven women (58%) were on anti-seizure medications (ASMs) throughout fertility treatment and pregnancy with only one on polytherapy. Levels of ASMs were followed and adjusted in 3 of the 7 (43%).  Eleven women (all with controlled epilepsy or epilepsy in remission) remained seizure free throughout fertility treatment. One woman, who had drug-resistant epilepsy, continued to have seizures throughout infertility treatment and pregnancy without an exacerbation of seizure frequency and with close monitoring and adjustment of ASMs.

Conclusions:

There was no seizure worsening in this cohort of 12 women with epilepsy undergoing assisted reproductive technology.