Can people with epilepsy get pregnant? It is possible to have children. But only under the guidance of a specialist and if you dare to take the risk yourself, because in reality it is often doctors who are afraid to advise epileptic patients to have children for fear of taking responsibility. What should I do if I am taking antiepileptic drugs and become pregnant? For female patients, there are two factors to consider. The impact of seizures. It is common to encounter patients with epilepsy who have significantly fewer seizures or whose seizures have stopped after pregnancy, and others whose seizures have instead worsened after pregnancy. In the 1990s, a retrospective analysis was done by foreign scholars and the results were that 15% of patients had an increase in seizure frequency and 24% had a decrease in seizure frequency, leaving more than half of the patients with no change in seizure frequency after pregnancy. The remaining half of the patients had no change in seizure frequency after pregnancy. Severe generalized tonic clonic grand mal seizures are hazardous. On the one hand, patients are often in a state of hypoxia, which in severe cases also leads to disturbances in the systemic internal environment, and on the other hand, patients may fall and have collisions, which can cause harm to the fetus. (There have been reports of intracranial hemorrhage in the fetus as a result of a fall during a seizure in a pregnant woman. Theoretically, long-term use of antiepileptic drugs increases the risk of pregnancy, including increased seizure frequency, risk of vaginal bleeding, fetal malformation, and neonatal hemorrhage. However, these conditions are increased in probability (relative to a healthy pregnant woman), the vast majority of cases remain normal, and there are measures that can be taken to reduce the risk. Appropriate choice of antiepileptic drugs. The traditional antiepileptic drugs carbamazepine (or Deridol), sodium valproate (or magnesium valproate, or Depakene), have definite evidence of effects on the fetus. The newer antiepileptic drugs lamotrigine (or Lipitor) and levetiracetam (or Kaipulan) are significantly better than the traditional antiepileptic drugs and should be given priority. It is also worth pointing out that lamotrigine, which has been partially documented in studies over the last decade, has shown no difference in its effects on the fetus compared to healthy pregnant women. In fact, my guideline in recent years has also been to choose lamotrigine first for female patients who are preparing to become pregnant, provided that seizures are controlled as much as possible. In male patients, it is very unlikely that the medication will affect the offspring when they are on long-term medication, and although there is no research data specifically in this area, in theory, the effects of the medication can be disregarded as long as the pregnancy is successful. In practice, I have often encountered cases of men with epilepsy whose wives can conceive and bear children normally while on medication. Whether seizures and medication affect male fertility is, of course, a separate issue.