coeliac disease and infertility

Last edited 08/2019 and last reviewed 11/2020

Coeliac disease (CD) is should be considered during the evaluation of infertility:

  • many females show a mean diagnosis of CD between ages of 40- 50 years (1)
    • CD may be diagnosed with a delay up to 10 years, the entire cycle of reproductive life is lost in women with undiagnosed CD (1)
    • prevalence of CD in unexplained infertility may be as high as 4-8% (2,3,4) - compares to a prevalence of approximately 1% in the general population (4)
    • infertility in untreated CD may be related to malabsorption e.g.iron and/or folate, and various deficiencies of vitamins and minerals
    • a meta-analysis has revealed (5):
      • a significant association was found between women with a diagnosis of infertility and undiagnosed celiac disease [OR 3.09 (95% CI 1.74-5.49)]
      • when considering those studies assessing the occurrence of infertility in subjects with already-diagnosed celiac disease, no difference was found between celiac disease patients and control subjects [OR 0.99 (0.86-1.13)]

    • the diagnosis of CD is often done in women without classic malabsorption symptoms (6)
      • the "silent" presentation causes a diagnostic delay with a prolonged dietary gluten exposure that may lead to a reduction of the fertile life period
      • though GFD in these patients might resolve the obstetric/gynecological problems related to CD - this does not happen in all patients
        • the potential of a GFD to have a positive effect on fertility is rationalized by the improvement of nutritional imbalance that includes malabsorption and blood deficiency of zinc, selenium, iron, folate; these elements may be important to develop coeliac disease-mediated reproductive disorders
  • note that CD may also cause a decrease in fertility in men by affecting sperm motility and androgen levels (7)

Reference:

Related pages:

coeliac disease