Abstracts

Rationale: Women with epilepsy (WWE) are at increased risk for reproductive health disorders including polycystic ovary syndrome (PCOS).¹ The most likely explanations are epilepsy itself, anti-seizure medications (ASM), and drug-related weight gain.² Others include modulation of the hypothalamic-pituitary-ovarian (HPO) axis and increased sex hormone-binding globulin concentrations.^3,4 Valproic acid use has been consistently associated with an increased risk of PCOS.⁵ One recent study from Africa found that WWE taking levetiracetam are more likely to have PCOS than WWE taking carbamazepine.⁶ This study aims to evaluate the effects of ASM exposure on PCOS symptoms in WWE in a contemporary cohort.

Methods: This is a cross-sectional study of 100 reproductive-aged WWE and 100 controls matched in age, BMI, ethnicity, birth country, and partner status. Women with or without epilepsy, age 18-45 years old were included. The exclusion criteria were a history of cancer, ovarian surgery, or non-epileptic seizures. A structured questionnaire and chart review were used to collect demographics, medical and reproductive health history, PCOS Rotterdam criteria, ASM history, seizure and diagnostic history, and seizure etiology via RedCap database. In patients without a previous diagnosis of PCOS, we used the Rotterdam criteria of two of three self-reported features to categorize them as patients with PCOS. We used Student’s t-test for continuous variables of equal variances, chi-square test for categorical variables, and Fisher’s exact test for categorical variables with frequencies of less than 5. Significance was set at p< 0.05.