مقالات پذیرفته شده در نهمین کنگره بین المللی زیست پزشکی
The Impact of Seizures and Antiepileptic Drug Treatments on Oocyte Quality in Women Undergoing In Vitro Fertilization (IVF)
The Impact of Seizures and Antiepileptic Drug Treatments on Oocyte Quality in Women Undergoing In Vitro Fertilization (IVF)
Ramin Ahmadzadeh,1,*
1. Department of Reproductive Biology, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
Introduction: Infertility in women with epilepsy is a complex clinical challenge that can result from hormonal imbalances, dysfunction of the hypothalamic-pituitary-gonadal (HPG) axis, or side effects of antiepileptic drugs (AEDs). Given the increasing use of assisted reproductive technologies (ART) like IVF, assessing the quality of oocytes in these patients is crucial. The aim of this study was to evaluate the impact of seizures and their pharmacological treatments on the quality of oocytes retrieved through ovarian puncture in women with epilepsy who are candidates for IVF.
Methods: In this study, data from women with epilepsy undergoing an IVF cycle were compared to a control group of infertile women with no history of seizures. The main parameters investigated included the number of oocytes retrieved, the number of mature (MII) oocytes, fertilization rate, quality of the resulting embryos, and the clinical pregnancy rate. The type and dosage of the antiepileptic drugs used and the frequency of seizures in these patients were also recorded.
Results: The findings showed that women with epilepsy obtained a smaller number of mature (MII) oocytes at the time of ovarian puncture compared to the control group. Furthermore, both the fertilization rate and the morphological quality of the resulting embryos were lower in this group. In a subgroup analysis, it was observed that women taking specific AEDs (especially those that affect the metabolism of sex hormones) had poorer oocyte quality. Although the frequency of seizures was also associated with a decline in oocyte quality, the pharmacological effects of the medications appeared to play a more prominent role.
Conclusion: Dysfunction of the HPG axis caused by seizures can lead to discoordination in the process of follicular maturation and ovulation. Additionally, some AEDs may interfere with the metabolism of sex hormones, potentially leading to a decrease in ovarian reserve or oocyte quality. These findings underscore the importance of thorough consultation before initiating ART treatments in women with epilepsy. Optimizing antiepileptic drug management in collaboration with gynecologists and neurologists can increase the chances of IVF success in these patients. Further studies are needed to investigate the precise mechanisms of how seizures and AEDs affect mitochondrial health and chromatin maturation in oocytes.