It’s completely normal to have concerns about how epilepsy—and the long-term use of antiseizure medication—may affect pregnancy, future children, or your own health. That’s why it’s essential to follow safe practices and proactively minimize avoidable risks. Ideally, pregnancy should be planned in advance in close coordination with your treating neurologist
It’s important to consider the possibility of future pregnancy for all adolescent girls and women of childbearing age—not just when actively trying to conceive. Valproate should only be prescribed to young women in exceptional cases, due to its known risks of birth defects.
f pregnancy is not currently desired, appropriate contraceptive methods should be used. Keep in mind that antiseizure medications and hormonal contraceptives can interact in ways that affect their effectiveness. Selecting the right combination in consultation with your physician is crucial. Never stop or adjust your medication without medical guidance—poor seizure control poses a greater risk to an unborn baby than well-managed medication.
When planning to conceive, it’s important to inform your neurologist. This allows time to adjust antiseizure treatment if necessary. It is recommended to start taking folic acid supplements (400–800 μg/day; in some cases up to 5 mg/day) at least three months prior to conception.
Women with epilepsy should be monitored regularly throughout pregnancy—not only by a gynecologist but also by a neurologist. Make an appointment with your neurologist as soon as you discover you’re pregnant.
In most cases, pregnancy in women with epilepsy proceeds without major complications. However, some women may experience a temporary worsening of seizure control, often due to nausea or weight-related changes that affect medication levels in the blood.
Most women with epilepsy can have a vaginal delivery, just like women without epilepsy. Your neurologist will prepare a medical report for the obstetrician, including relevant information about your epilepsy, delivery recommendations, and guidance on breastfeeding with your current medication. A cesarean section is rarely required specifically because of epilepsy. It is important to continue taking your medication at the regular times and doses throughout labor and delivery.
After giving birth, regular follow-up with a neurologist remains crucial. Hormonal shifts and weight changes can alter the levels of medication in your blood, so monitoring is necessary to prevent under- or overdosing.
The postpartum period can be physically and emotionally demanding, especially for mothers with epilepsy. Maintaining consistent medication and a regular sleep schedule is critical. Partners should be actively involved in nighttime infant care to support maternal health.
Fertility challenges affect approximately 20% of couples in the general population and among people with epilepsy. Many turn to fertility clinics for support.
For individuals with epilepsy, the success rates for assisted reproduction are comparable to the general population. Women with epilepsy can expect the same likelihood of a successful pregnancy per embryo transfer as other women undergoing fertility treatment. Medication management when using assisted reproduction should follow the same clinical guidelines as for naturally conceived pregnancies.
Helpful information about pregnancy, parenting, and infant care for individuals with epilepsy can be found in the brochure Living with Epilepsy published by Společnost E.
Special attention is recommended for men taking valproate, according to the European Medicines Agency (EMA) and the Czech State Institute for Drug Control (SÚKL).
Some retrospective studies from Denmark, Sweden, and Norway suggest a potential increased risk of neurodevelopmental disorders in children fathered by men who took valproate within three months before conception, compared to those who used lamotrigine or levetiracetam.
While the risk has not been definitively confirmed, caution is advised. Valproate should be prescribed only when clearly justified, and patients should be informed of the potential risk. When possible, alternative antiseizure medications should be considered.
29. 10. 2024
29. 10. 2024
29. 10. 2024
