Oxidative stress and risk of polycystic ovarian syndrome in women with epilepsy: implications of malondialdehyde and superoxide dismutase serum levels on female fertility

Epilepsy is a common neurologic disease and has important implications for women’s fertility, as approximately half of the epileptic women have reproductive disorders. Oxidative stress is a key contributor in the pathogenesis of polycystic ovary syndrome (PCOS) and epilepsy. We aimed to investigate the role of malondialdehyde (MDA) and superoxide dismutase (SOD) serum levels as predictors of PCOS in women with epilepsy (WWE) and to evaluate the possible relationship between oxidative stress and epilepsy characteristics as well as clinicomorphological features of PCOS. A cross-sectional study enrolled 130 WWE. They were classified to two subgroups; women with PCOS (n=50) and women without PCOS (n=80) according to Rotterdam criteria. Metabolic markers and markers of PCOS were measured. Serum MDA and SOD concentrations were estimated by enzyme-linked immunosorbent assay. Our results revealed higher levels of MDA and SOD in WWE, in particular, women with PCOS. Moreover, serum MDA and SOD levels were significantly positively correlated with PCOS phenotypes. Linear regression test revealed that Low-density lipoprotein cholesterol (LDL) and luteinizing hormone (LH) were the main predictors of serum MDA levels in PCOS, whereas BMI and LH were the main predictors of serum SOD levels. Regarding antiepileptic medication, there were significantly higher levels of MDA and SOD in patients treated with valproic acid compared with the ones treated with carbamazepine. The high levels of MDA and SOD among WWE, in particular, women with PCOS, were positively correlated with obesity indices and PCOS phenotypes. Thus, we recommended avoid using valproic acid in women during childbearing period.