The prevalence of coeliac disease in infertility

Abstract

An increased incidence of reproductive problems, including infertility, miscarriage, low birth weight newborns, and shorter duration of breast-feeding, are known to exist in women with coeliac disease; some of these conditions are improved by a gluten-free diet. We have tried to ascertain the prevalence of coeliac disease in 99 couples who were being evaluated for infertility, compared with the known prevalence of silent disease in the population of Northern Sardinia, in which it is endemic. Of all women, four tested positive for at least two out of three markers: immunoglobulin A (IgA) antigliadin, immunoglobulin (IgG) antigliadin, and anti-endomysium antibodies, and underwent a jejunal biopsy; three had histological evidence of coeliac disease. One male partner was positive for two markers, and had a diagnostic jejunal biopsy. The prevalence of coeliac disease in infertile women seems higher (three out of 99, 3. 03%) in the study group than in the general population (17 out of 1607, 1.06%), and particularly in the subgroup with unexplained infertility (two out of 25, 8%, P < 0.03). Screening for coeliac disease should be part of the diagnostic work-up of infertile women, particularly when no apparent cause can be ascertained after standard evaluation.

Screening for Celiac Disease in Children With Type 1 Diabetes

“…The frequency of reproductive disorders in women with subclinical celiac disease is currently unknown. However, studies in Finland (26) and Sardinia (27) detected celiac disease in 4 -8% of women with unexplained infertility. At least some of the women conceived within the first year after initiation of a GFD.…”

RISK OF INFERTILITY IN PATIENTS WITH CELIAC DISEASE: a meta-analysis of observational studies

“…Of these, 395 were excluded, and eighteen potentially relevant studies were evaluated. Six studies were excluded because they did not fulfilled elegibility criteria: three studies lacked a control group (5,13,17) , a large population-based study (9) was not designed to compare infertility prevalence in celiac subjects and used U.S. general population as a control group; another study (20) used an inadequate control group (previously known prevalence of silent CD in the northen Sardinian population) and another one (7) assessed the risk of infertility only in male subjects and used Crohn's disease patients as control group. Finally, as shown in Figure 1, twelve studies were included for analysis.…”

“…There has been evidence indicating a link between CD and reproductive disorders, such as recurrent abortions (3) . The relationship between CD and infertility has been previously assessed by several studies, with contradictory results (13,20) . Hence, we sought to perform a systematic review and meta-analysis of current evidence on this particular subject.…”

Celiac Disease and the Risk of Infertility

“…Nevertheless, in different series, celiac infertile women with total or subtotal villous atrophy failed to show signs of nutritional deficits [23,24,25]. For example, in the series published by Collin et al, celiac patients showed neither severe malnutrition nor signs of trace element deficiency; only two had iron deficiency [23].…”