Community Forum

Low sperm count...anybody?

I read on this website that AED,specially carbamazepine and phenytoin, affects sperm count,sperm mobility,fertility etc.

Has this affected any of you or anybody you know?
What did you do about it?

I need advice.
Thank you.

My husband has E since he was a child and since then he was on phenytoin.He also have taken keppra since last 3years.
At the moment he is on keppra and tegretol retard.The phenytoin was been withdrawn.


I've been taking Dilantin (300MG) since 1997 and we had our first baby in 2007.  It took almost no effort.  So, I cannot say that this was an issue for me.   


im keppra and eppilem i had bad time getting and erection  or maintaneing one due to meds my sperm has been severly affected go and and see an urologist get him too do test too find out how low testarone is 

I have been taking phenytoin for about 20 years and have subsequently developed a number of conditions due to being prescribed a dose far higher than what I have eventually discovered to be the maximum safe dosage. My kidneys have been damaged, resulting in a a potential transplant, my eyesight has been affected so I have had to relinquish my driving license andnow being registered blind, something which has also affected my ability to work and take part in and enjoy a number of activities that I did before, and I also have a very low sperm count which, having made various enquiries, I can only relate to the excessive amounts of phenytoin that I had been taking. Although it is a very effective drug I would be cautious about recommending it to people. Having kidney damage, loss of sight and being infertile by the age of 34 is enough to make me doubt its suitability as an anti-epilepsy drug treatment.

Hi Anie,  just noticed this while checking out the mens site and wanted to chip in.  I know I'm late but here goes.

Tegretol and phenytoin for past 27 years or close to.  No problems with sperm at all.  However the best advice is read the instructions and talk to the doc.

Don't know if this helps.



 Hi! Don't know if I'm lucky or what, but I was on Dylantin for about 6 years and I had no problems with any of these things. I'm a father of 3, ages 13,11, and 8. So I didn't have any problems. We chose to stop, couldn't afford I started my seizures at 18, had my first child at 24. About the time I switched to Depakote.

Hello. I am a bit like Beau below. I have been taking a rather low dose of Tegretol (1 in the mornoing and 2 at night - all 200mgs tablets) and have absolutely no interest in sex at all. I go to bed and am asleep in minutes. I try but there is no interest at all and I am afraid that my wife suffers because of this. And no I haven't mentioned this to either the neurologist or my wife.

That's my experience anyway. Sleep like a log for 9 hours too.



Hi, I will recommend an artificial insemination for both of you. Look it doesnt always mattern about the sperm count. Maybe your husband is giving out right number of sperm cells but these cells might not be motile. Visit a specialist and sort out the original problem. Maybe artifical insemination methods might help.


Side Effects & Drug Interactions


If adverse reactions are of such severity that the drug must be discontinued,
the physician must be aware that abrupt discontinuation of any anticonvulsant
drug in a responsive epileptic patient may lead to seizures or even status epilepticus
with its life-threatening hazards.

The most severe adverse reactions have been observed in the hemopoietic system
(see BOXED WARNING), the liver and the cardiovascular

The most frequently observed adverse reactions, particularly during the initial
phases of therapy, are dizziness, drowsiness, unsteadiness, nausea, and vomiting.
To minimize the possibility of such reactions, therapy should be initiated at
the low dosage recommended.

The following additional adverse reactions have been reported:

Hemopoietic System: Aplastic anemia, agranulocytosis, pancytopenia,
bone marrow depression, thrombocytopenia, leukopenia, leukocytosis, eosinophilia,
acute intermittent porphyria.

Skin: Toxic epidermal necrolysis (TEN) and Stevens-Johnson syndrome
(SJS) (see BOXED WARNING), pruritic and erythematous
rashes, urticaria, photosensitivity reactions, alterations in skin pigmentation,
exfoliative dermatitis, erythema multiforme and nodosum, purpura, aggravation
of disseminated lupus erythematosus, alopecia, and diaphoresis. In certain cases,
discontinuation of therapy may be necessary. Isolated cases of hirsutism have
been reported, but a causal relationship is not clear.

Cardiovascular System: Congestive heart failure, edema, aggravation
of hypertension, hypotension, syncope and collapse, aggravation of coronary
artery disease, arrhythmias and AV block, thrombophlebitis, thromboembolism,
and adenopathy or lymphadenopathy.

Some of these cardiovascular complications have resulted in fatalities. Myocardial
infarction has been associated with other tricyclic compounds.

Liver: Abnormalities in liver function tests, cholestatic and
hepatocellular jaundice, hepatitis; very rare cases of hepatic failure.

Pancreatic: Pancreatitis.

Respiratory System: Pulmonary hypersensitivity characterized
by fever, dyspnea, pneumonitis, or pneumonia.

Genitourinary System: Urinary frequency, acute urinary retention,
oliguria with elevated blood pressure, azotemia, renal failure, and impotence.
Albuminuria, glycosuria, elevated BUN, and microscopic deposits in the urine
have also been reported.

Hi all,


I read this thread a long ago (or one like it) as my wife and I were experiencing problems conceiving.

 A short history:

 We conceived twice - in 2002 and 2003. Both in the first month of trying. No fertiility problem there then.

 In late 2003 I was diagnosed with AVM which had begun to cause complext partial seizures. I was prescribed Tergretol (which I think is Carbamazepine) to control these. I needed a fair dose - 1400mg/day - which eventually completely stopped my seizures.

Since 2005 we have been trying for another baby but nothing was happening. This was despite conceiving TWICE before, both on the FIRST MONTH of trying (as I said above).

 We had my wife checked out (ovulation tests, etc) and everything was fine. I had a test which showed low count, then a retest showed evn lower. My doctor said it was impossible for us to have children - but couldn't explain we had conceived so easily before.


 So having read up on the possible effect of AEDs on fertility, I pushed my epilepsy nurse for a change in drugs but she was adamant that it would not be the drugs affecting it. More pushing (eventually involving a consultant neurologist) finally saw me given a change in  AEDs which started around October 2007. 

 By end of Feb 2008 I was completely off the Tegretol having dosed up to 1500mg/day on Keppra (Levetiracetam) by December. I have had no seizures during the switch which is great.


On 31st March 2008, my wife (5 days late) took a pregnancy test and it came back positive. We had not even been trying that hard for a child since we though it would take a while for effects (if any) of AEDs to go away. It's still not confirmed by a doctor but this, for me at least, is living proof that fertility IS affected by some AEDs but also that recovery is possible.

I hope this can bring some hope to anyone affected by these issues. 

  cheers, James. 


Just wanted to say thanks to everyone for posting their information as it has helped me to start tests etc on my partner that has E.

We have been trying to conceive for a while now, i have done everything i can think of to 'catch the sperm' and got nowhere. I know i can have kids (got 4 already) but he wants one of his own...... so far, no good.

I spoke to our GP about the possibility of the AED effecting him and was told, probably not - this has given me more ammunition to take things further.

He is on a very high dose - Keppra 1000mg/day, Tegretol 800mg/day, Valproate Sodium 2500mg/day...... so i think there is a very high chance of this being a problem.

Thanks again

My experience of years of swapping meds and well having a few to many girl friends....

While on Dilantin I got my high school girl friend pregnant.

Was switched to Tegretol shortly thereafter never had another pregnancy scare.

Switched to Topamax sex drive dropped off a little. Added Keppra sex drive died, may it rest in peace.....

I plan on asking my neuro if Viagra will control epilepsy!!!!



Are you taking any other drug instead of Tegretol?


My hubby is on Tegretol retard 800mg/bd + Keppra 1500mg/bd.



Hi Anie,

It's been years since I've been on this site -sorry if this reply is too late :-(

I was on Tegretol 1200mg/day.

I switched completely to Keppra 1500mg/day - no Tegretol at all.

 For me this has cured my infertility which was clearly caused by the Tegretol. We conceived twice since changing (we lost the first at 3months) but the second conception led to our baby daughter who is now 10 months old and doing well. No problems during pregnancy or child birth - everything was normal.

 Hope this helps.

 I'm guessing different combinations affect people in different ways but for me, the Tegretol was what caused it.



Hello Bill


I think you should talk to your wife about this.


I have low(er) sperm count as well. And my desire has gone down a bit. I am on Keppra. Maybe there's a connection between sperm count and Keppra? Anyone know of medical evidence to this effect?


is limited information about fertility in men with epilepsy. Some
studies have suggested that men with epilepsy may have reduced
fertility compared with men in the general population. This may be due
to the effect of epileptic activity or anti-epileptic drugs (AEDs) on
testosterone levels. Some AEDs may reduce the production of sperm or
affect the quality of a man’s sperm, in particular carbamazepine,
oxcarbazepine and sodium valproate. Nevertheless, the majority of men
with epilepsy have no problems with fertility and father healthy


Male infertility

Specialized Populations > Men > Male infertility

Author: Joyce Cramer

Some men taking antiepileptic drugs experience decreased libido and
potency, low sperm count, decreased sperm viability, and decreased
likelihood of ovum fertilization. Herzog et al4
assessed 20 unselected men with complex partial seizures for comparison
with impotent men seen in an endocrine clinic. Hypogonadotropism was
found in 20% of men with epilepsy compared to 25% of impotent men,
hypergonadotropism in 10% and 7%, respectively, and hyperprolactinemia
in 10% and 8%, respectively. They suggested involvement of the temporal
lobe discharges because of the similar incidence of endocrine disorders in this small group of men with epilepsy matching the men diagnosed with impotence.

They compared men with partial-onset epilepsy taking carbamazepine
or oxcarbazepine with men with generalized epilepsy taking valproate.
The findings could be expected based on the enzyme-inducing properties
of carbamazepine and oxcarbazepine at higher doses, whereas valproate
is an enzyme inhibitor. They also found morphologically abnormal sperm,
low sperm motility, and reduced testicular volume among all epilepsy
groups compared to healthy controls.

AEDs also might affect spermatogenesis in humans as they do in
vitro. Carbamazepine inhibited testosterone synthesis in Leydig cells,
phenytoin inhibited testosterone conversion from progestins, and
valproate had the least effect on testosterone.5 This in vitro model showed the differential effects of each AED on the metabolic pathway of sex steroid hormones. 






Smile :)

my hubby and I have been trying to have a baby since 2003. He was on Dilantin for about 10 yrs and they switched him to Lamotrigine. I got my Thyroid under control back in March. So nothing has happened yet with getting pregnant. We was beginning to think it was him. So hopefully we will get the money to go get him checked out next month. He does have a dr. appt with his neurologist up in Portland. And those fertility tests for men, don't buy them. They are a waste of money for 32 bucks when you can go to a lab and pay 60 bucks to get the whole kit and caboodle done. but anyways does Lamotrigine actually have bad effects for sperm???
Crystal & Steve


I was taking Lamictal (Lamotrigine).  I took the medicine for around 4-5 years (+/-).  my dosage got to 250mg 2x a day.  I had a seizure valentine's day which prompted my doctor to switch me to keppra.  My sexual stamina and desire while on Lamictal was flat lining.  Since being on Keppra, my fiancee has noticed a huge difference in my cravings.  The situation was reversed before: she was the sex starved nympho and now the table has turned since I began Keppra 

Oh you naughty Nymphos!

I have been on some of those medicines too. My sex drive is fairly good. I haven't kept a journal so i can't know for sure but perhaps my sex drive has gone down a notch. My junk works just fine and i definitely get in the mood for bedroom aerobics atleast a 2-3 times a week(if i'm a good boy), so over all not too bad at all. I have never gone to a doc/sperm bank but i would hope i have Super Sperm.


All the best my Nymphos


Hi there:

I have been taking Tegretol for over 20 years in steadily increasing dosages. My wife and I were not able to get pregnant due to my "unexplained" lower sperm count, motility, etc. The doctor told me Tegretol has never been proven to lower these counts, but my experience tells me otherwise.

For what it's worth...

Hi Schuey.
Thank you for your reply.
Maybe you should talk to your doctor about this problem and take some print outs as a "proof".

Smile :)

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