Ovarian reserve markers in women of reproductive ages with epilepsy

The objective of this study was to examine ovarian reserve parameters in women with epilepsy compared to women without epilepsy. A total of 80 women with epilepsy (WWE) from the epilepsy clinic at Rigshospitalet, Denmark, participated and completed the study between 2018-2022. A historical cohort collected from 2008 to 2010 of 418 women without epilepsy and no prior diagnosis of infertility was used as control. Ovarian reserve markers, including serum anti-Müllerian hormone (AMH) and antral follicle count (AFC) measured via transvaginal ultrasound, were assessed during the early follicular phase (cycle days 2-5). Age-adjusted ovarian reserve parameters were compared between WWE and controls, as well as among subgroups of WWE. There was no difference in AMH between the groups with mean AMH of 21.9 (15.0) pmol/L and 21.7 (18.0) pmol/L, respectively (p = 0.93). AFC was higher in WWE with a mean of 28.3 (16.4) compared to 22.7 (12.0) in the control group (p = 0.01). The difference in AFC remained significant after adjusting for age (p = 0.035). No differences were found when comparing subgroups of WWE based on the dominating seizure type. Overall, women with epilepsy did not have diminished ovarian reserve as age-adjusted markers of ovarian reserve (AMH and AFC levels) were comparable to a control group of women without epilepsy. In daily clinical practice, this provides reassuring and important information to communicate to women with epilepsy of reproductive age, who are often concerned about their reproductive health.