Effect Of Epilepsy On Female Reproductive Function And Its Mechanism

This paper was conducted to study the effects of epilepsy on the reproductive function of women from the research of the clinic and basic medicine in order to reveal the mechanism of reproductive disorder and improve the reproductive function and the life quality. Based on the review of the influence of epilepsy on the reproductive function of women, firstly from the point of clinical view to study ovarian artery hemodynamics in women of childbearing age with epilepsy and to reveal that the abnormality of ovarian blood flow might be one of the mechanism of reproductive disorder. The index of ovarian artery blood flow combined with the level of sex hormone and the counts of antral follicle can predict the ovarian reserved function at early-stage. Then the influence of seizure on the estrous cycle, body weight, sex hormone, the uterus and ovary weight and the constructure of tissue was studied by the female Wistar rat model with epilslepsy. It showed that the ovarian reserved function decreased. It revealed that epileptic seizure might do harm to uterus and ovary, and that the pathological changes of the reproductive organ might be one of the mechanism of reproductive disorder.Part I Study ovarian artery hemodynamics in women of child-bearing age with epilepsyObjectiveOvarian artery hemodynamics, the relationship between ovarian artery blood flow and epileptic seizure were studied in women of child-bearing age with epilepsy in order to provide the evidence for the comprehensive therapy of epilepsy.MethodsForty female patients of child-bearing age with epilepsy in the epilepsy group were observed and twenty-nine healthy women with of child-bearing age were as the control group. The two groups were marched for age. The peak systolic velocity (PSV), the end-diastolic velocity(EDV), the resistance index(RI) of the ovarian artery, ovarian volume and the antral follicle numbers in the early follicular phase were measured with the color Doppler ultrasonography. At the same time the blood samples were taken from all of the cases for the analysis of estradiol(E2), progesterone(P) and follicle-stimulating hormone(FSH), luteinizing hormone(LH) by radioimmunoassay.Results①The PSV values of ovarian artery in the epilepsy group were significantly lower compared with those in the control group(p<0.05).②In the epilepsy group the levels of E2were higher and the levels of progesterone were less than those in the control group (p <0.05). The antral follicle counts in the epilepsy group were lower than those in the control one(P<0.05).③Multi factor linear regression ananysis showed that the seizure frequency, plasma progesterone concentration were the main factors of the influence on the PSV of ovarian artery(p<0.05).Conclusions The ovarian artery hemodynamics was abnormal in women of child-bearing age with epilepsy and the seizure frequency, plasma progesterone concentration were the main factors of the influence on the PSV of ovarian artery. The abnormality of ovarian blood flow might be one of the mechanism of reproductive disorder of epileptic patients. The significant relationships were found between the blood stream and function status of the ovaries. Therefore if the monitor of the ovary artery blood flow and the evaluation of the ovarian functions were performed early, it can improve the reproductive function and the life quality of epileptic patients. Part Ⅱ Effect of epilepsy on reproductive and endocrine function in female ratsObjectiveTo explore the impact of epilepsy on the reproductive and endocrine function in adult female Wistar rats and the possible mechanism.MethodsThirty adult female Wistar rats with regular estrous cycle were selected and rats were randomly divided into the two groups:the control group(n=10) and the model group(n=20). The rats in the model group were treated with lithium-chloride and pilocarpine intraperitoneally to induce epilepsy. The rats in the control group were given normal saline instead of pilocarpine. The behavior of rats, the epileptic seizure frequency, the latency and the mortality were observed. The estrus cycles were observed by vaginal smear every day for one week in the sixth week after the treatment. All of the rats were killed on estrus, and then the blood was taken and the sexual hormone levels in serum (follicle-stimulating hormone, luteinizing hormone, testosterone, estradiol, progesterone and prolactin) were measured by radioimmunoassay. The uterus and ovary were separated. The body weights of the rats, uterus and ovary weights were measured. The organ coefficient of uterus and ovary were calculated. The pathological section of uterus and ovary were performed and dyed by hematoxylin eosin staining and the pathological changes were observed under the light microscope. Statistical analysis was carried out using SPSS16.0software and α=0.05was considered statistically significant level.ResultsThe rats in the control group were no dead and did not develope seizure and the estrous cycle was stable. However, in the rats from the model group three rats were found to be died, and four rats were not to be induced to epilepsy model. So thirteen animals in the model group were induced ultimately to the epilepsy seizures successfully. The successful rate for constructing epilepsy model was65%. The experiment showed that the weights of the rats, the uterus and ovary weights and the coefficient of uterus in the epileptic with success model group were decreased, the period of the estrous cycles and the estrous anestrus of the rats were extended, and that the concentrations of luteinizing hormone and progesterone were lower. These index in the model group with success were compared with that in the control group and in the model group without success and significant difference was found(p<0.05). Under the light microscope the number of uterine gland, the blood flow within stroma ovarii and the number of ovarian follicle in the epileptic model with success were lower than that of the controls and of the model group without success(p<0.05). All the examinational index of the control group compared with that of the model group without success were found no significant differences(p>0.05).ConclusionsThe experiment of rat epilepsy model treated with lithium-chloride and pilocarpine showed that epilepsy can influence the estrous cycles, body weight, sexual hormone level, and injury to the histological structure of the uterus and ovary. In short of word, epilepsy can do harm to the reproductive development of the adult female Wistar rats, and the pathological changes of the reproductive organ might be one of the mechanism of reproductive disorder.