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Valproate and Male Fertility — SCE Neurology MCQ

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HardEpilepsy & Seizure DisordersValproate and Male FertilitySCE Neurology

A 38-year-old man with epilepsy is considering fathering a child. He has been on sodium valproate for 5 years. Per the January 2025 NICE NG217 update, what advice should be given regarding male fertility and valproate?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — He should be advised that valproate may affect sperm and he should use effective contraception; he should discuss treatment options if planning a family within the next year

The January 2025 update to NICE NG217 requires that men taking valproate who are planning a family within the next year should discuss potential fertility risks and treatment options with a healthcare professional. Men should be advised to use effective contraception (condoms, plus contraception used by a female partner) during valproate treatment and for 3 months after stopping. This reflects emerging evidence of potential sperm effects. A: Valproate may affect sperm parameters. C: Immediate cessation is not required but a discussion is mandatory. D: Safety is not established. E: Folic acid is relevant for women, but the key issue for men is the fertility discussion.

Reference: NICE NG217 (2025); MHRA Valproate Guidance (2024)