Year after year, International Epilepsy Day is celebrated every second Monday in February. At IVI we want to shed light on the implications that this disease can have on maternity wishes. In addition to clarifying the question of whether epilepsy is hereditary. For this reason, we have asked Dr. Marcos Ferrando, Medical Director of IVI Bilbao, Santander, Donostia, Vitoria and Logroño to talk to us about whether it is possible to be a mother with epilepsy.
Is it possible to be a mother with epilepsy?
First of all, it should be mentioned that, according to the Spanish Society of Neurology (SEN), about 400,000 people suffer from this disease. In addition, each year between 12,400 and 22,000 new cases are diagnosed. Only in Europe some 6 million people suffer from epilepsy and 400,000 new cases are added annually.
Epilepsy is a very common chronic condition among women of reproductive age. Increasingly, women with this and other chronic diseases are trying to achieve a pregnancy. Despite the fact that epidemiological studies may indicate that there is a lower birth rate in the group of women with epilepsy of reproductive age, this does not mean that these women present a higher rate of infertility, since this fact can be associated with different causes. For example, it could be related to social factors, such as less stable relationships or women considering not having children due to their epilepsy.
Assisted reproduction for women with epilepsy
Consulting the study “The efficacy of assisted reproduction treatment in women with epilepsy”, published by Professor Due Larsen et al in 2021, we can see how women with epilepsy and some fertility problem have similar chances of achieving pregnancy through reproductive medicine. , compared with those without epilepsy.
These are novel and reassuring findings on the efficacy of reproductive medicine in women with epilepsy. There is a reality, and that is that the number of epileptic women during their childbearing years increases progressively. Many of them do not have children and, due to the growing delay in the age to be a mother, they may need reproductive treatment to achieve it. Against this background, studies like this one help to clear up many of the concerns that may arise around the binomial ‘epilepsy and maternity’.
Does it affect epilepsy during pregnancy?
Therefore, epilepsy is not a contraindication to achieving pregnancy. The risks associated with this disease during pregnancy can be reduced through interventions carried out before and during it.
The only factor to take into account as a fundamental requirement for every patient with epilepsy, as well as with any chronic condition, is that the disease is controlled before starting reproductive treatment. The goal should be optimal control of seizures before attempting pregnancy and a comprehensive review of antiepileptic medications. For this, multidisciplinary work will be essential in which both the neurologist and the expert in maternal-fetal medicine intervene to offer the patient the greatest security during her reproductive process.
Is epilepsy hereditary?
It is true that epilepsy is produced by complex and varied causes. So much so that we could consider this disease as a symptom associated with various medical conditions, rather than as a disorder in itself. Therefore, any damage or alteration in the central nervous system can end in epilepsy. Around 50% of diagnosed cases of this disease currently have no known origin. In the other half, it may be due to a variety of causes, including: brain damage, tumors, infectious diseases, congenital malformations, and genetic causes.
As of today, thanks to technical advances in molecular genetics, in approximately 1 in 4 cases of epilepsy some genetic alteration can be identified that can be considered the cause, having described more than 200 genes associated with this condition. In cases where a genetic cause is identified, reproductive options can be discussed with women or couples in order to prevent the birth of an affected child. Among these reproductive options would be preimplantation genetic diagnosis (PGT-M), an advanced technique that allows genetic analysis of embryos and thus transfers only those that have not inherited the alteration.
