The efficacy of assisted reproductive treatment in women with epilepsy

ABSTRACT Research Question The question of interest for this study is to examine the chance of a live birth following assisted reproductive technology (ART) treatment in women with epilepsy, compared to women without epilepsy. In sub-analyses the chance of biochemical and clinical pregnancies is analysed, and the impact of anti-epileptic drugs (AED) treatment prior to embryo transfer. Design This register-based cohort study is based on the Danish ART register comprising all women with an embryo transfer during 2006 through 2017, comprising 730 ART treatments in 264 women with a history of epilepsy, and 128,387 ART treatments in 42,938 women without epilepsy. Adjustments were made for comorbidity, women's age, calendar year, the type of infertility treatment, and the cause of infertility. A possible impact of AED use at the time of the embryo transfer was studied in a sub-analysis. The primary outcome was live birth within a period of 140-308 days after the date of embryo transfer. Results The adjusted odds ratio for a live birth per embryo transfer in women with epilepsy, relative to women without epilepsy, was 1.06 (95% CI 0.88-1.28). The adjusted odds ratio for live birth among users of AED was 1.22 (95% CI 0.77-1.92), relative to women who had stopped the use of AED prior to embryo transfer. Conclusions The chances of a live birth per embryo transfer were similar in the women with and without epilepsy. These are novel and reassuring findings on the efficacy of infertility treatment in women with epilepsy.