Active ingredient: Valproic acid; Sodium valproate; Valproate semisodium (divalproex sodium)

Brand Name: Depakene®, Depakote®, Epilim®, Depakine®

Drug class: Antiseizure medication (ASM); antiepileptic drug (AED); broad-spectrum anticonvulsant; mood stabilizer

Mechanism of Action:

Valproic acid (valproate) is a broad-spectrum antiseizure medication that is used as a first-line treatment for epilepsy and as a second-line option for bipolar disorder and migraine prophylaxis. By increasing central γ-aminobutyric acid (GABA) activity and modulating voltage-gated sodium and calcium channels, valproate effectively suppresses neuronal excitability. However, these pharmacological effects are accompanied by clinically relevant endocrine and reproductive adverse effects

Effect on fertility biomarkers

In addition to its well-established teratogenicity, valproate has been associated with alterations in reproductive function in both women and men. In women, treatment may disrupt the hypothalamic–pituitary–ovarian axis, leading to menstrual irregularities, including delayed or absent menstruation, and has been associated with polycystic ovary syndrome (PCOS) and other endocrine disturbances in susceptible individuals. These changes may be accompanied by alterations in fertility-related biomarkers, including ovulatory function and reproductive hormone profiles, potentially reducing female fertility. I n men, valproate has been linked to impaired spermatogenesis and reduced semen quality, with evidence suggesting that these effects may be reversible after treatment discontinuation. Because prenatal exposure to valproate carries a high risk of major congenital malformations and neurodevelopmental disorders, its use in women of childbearing potential is subject to strict regulatory restrictions, including comprehensive pregnancy prevention measures.

First
Second
Third
…

ovulation

View the chart

References:

European Medicines Agency (EMA) commissioned a large-scale real-world evidence study through the DARWIN EU® network to characterize valproate utilization among females aged 12–55 years across Europe between 2010 and 2022.

Comments

If you have used this medication and monitored fertility biomarkers, please share your experience.

Disclaimer: The information provided may not include all possible interactions or side effects of medication. The effects on fertility biomarkers can vary and may depend on the dosage, how long the medication is used, the medical condition, or other factors. This database is for informational purposes only and should not replace professional medical advice, diagnosis, or treatment. Always consult your healthcare provider or a qualified health professional if you have questions about medications, fertility, or medical conditions.