Artama Miia, Isojärvi J I T, Auvinen A
School of Public Health, University of Tampere, Tampere, Finland.
Hum Reprod. 2006 Sep;21(9):2290-5. doi: 10.1093/humrep/del194. Epub 2006 Jun 3.
Antiepileptic medication use affects reproductive endocrine function, but its impact on fertility is not well known.
All epilepsy patients, who were approved as being eligible for reimbursement for antiepileptic drug (AED) costs from the Social Insurance Institution (SII) of Finland for the first time 1985-94, were identified from the SII database. A reference cohort without epilepsy was identified from the Finnish Population Register Centre. Information on AED purchases 1996-2000 was obtained from the SII database through computerized record linkage with the unique personal identification number assigned to all residents of Finland. The three AEDs included were carbamazepine, oxcarbazepine (OXC) and valproate.
Birth rate was lower in both men and women with epilepsy on AEDs than in the reference cohort without epilepsy. However, compared with patients not using AED during the study period, the birth rate was lowered only among men on OXC [rate ratio (RR) = 0.52, 95% confidence interval (CI) = 0.32, 0.84].
The birth rate was lower in both women and men on any of the three AEDs compared with the reference cohort without epilepsy. However, a statistically significant difference between treated and untreated patients was only seen in men on OXC. It is unclear to what extent the differences found in this study are due to social or biological factors.
抗癫痫药物的使用会影响生殖内分泌功能，但其对生育能力的影响尚不明确。
从芬兰社会保险机构（SII）数据库中识别出所有在1985年至1994年首次被批准可报销抗癫痫药物（AED）费用的癫痫患者。从芬兰人口登记中心确定一个无癫痫的对照队列。通过与分配给所有芬兰居民的唯一个人识别码进行计算机化记录链接，从SII数据库获取1996年至2000年的AED购买信息。所纳入的三种AED分别为卡马西平、奥卡西平（OXC）和丙戊酸盐。
服用AED的癫痫男性和女性的出生率均低于无癫痫的对照队列。然而，与在研究期间未使用AED的患者相比，仅服用OXC的男性出生率降低[率比（RR）=0.52，95%置信区间（CI）=0.32，0.84]。
与无癫痫的对照队列相比，服用三种AED中任何一种的男性和女性的出生率均较低。然而，仅在服用OXC的男性中观察到治疗组和未治疗组患者之间存在统计学显著差异。尚不清楚本研究中发现的差异在多大程度上是由社会因素或生物学因素导致的。
