Fertility disorders associated with celiac disease

By BSc, MSc (embryologist) and BA, MA (fertility counselor).
Last Update: 02/19/2015

Celiac disease is an inherited autoimmune disease characterized by the intolerance to gluten, present in wheat and other grains and cereals such as barley, rye and oat. Affected people present an inflammatory reaction in the mucosa of the small intestine after they have ingested gluten (protein). This inflammatory reaction hinders the digestion and the absorption of nutrients.

Experts believe that 1 in 100 people is celiac, the most common intestinal disorder. Although the exact reason for this disease is not known, it is known that women are twice as likely to develop it as men.

The immune system of affected people overreacts in the presence of this protein and "attacks" the areas infected, affecting the microvilli of the intestine and preventing the absorption of macro and micronutrients.

Celiac Disease Diagnosis

Celiac disease (CD) can occur at any time of life, from infancy to adulthood. It is estimated that 75% of infected people have not been diagnosed. The main reason is that, until recently, only the most common symptoms were known and this disease can manifest in an atypical way. The new diagnostic tests, along with advances in research, have revealed different types of celiac disease, which are:

  • Symptomatic celiac disease: the symptoms are the most common and well-defined.
  • Subclinical celiac disease: there are no symptoms but the diagnostic tests are positive.
  • Latent celiac disease: these patients are intolerant to gluten only on certain occasions.

The most common symptoms are diarrhoea, abdominal swelling and rashes. Other less common manifestations also exist, some related to gynaecology and obstetrics.

Some atypical symptoms of celiac disease are related to fertility problems, especially in women. Many of these women have their first period later than usual, have secondary amenorrhea, have difficulty in conceiving, have a higher incidence of spontaneous miscarriages, suffer from premature menopause, etc.

Many women with unexplained infertility could be celiac and don't know it, because their disease is of the asymptomatic variety. It would be advisable to perform a serological screening test to rule out the disease. If the result of the test is positive, the patient should maintain a gluten free diet throughout her life and try to get pregnant once again.

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 Cristina Mestre Ferrer
Cristina Mestre Ferrer
BSc, MSc
Bachelor's Degree in Biological Sciences, Genetics & Human Reproduction from the University of Valencia (UV). Master's Degree in Biotechnology of Human Assisted Reproduction from the UV and the Valencian Infertility Institute (IVI). Embryologist at IVI Barcelona. More information about Cristina Mestre Ferrer
Adapted into english by:
 Sandra Fernández
Sandra Fernández
Fertility Counselor
Bachelor of Arts in Translation and Interpreting (English, Spanish, Catalan, German) from the University of Valencia (UV) and Heriot-Watt University, Riccarton Campus (Edinburgh, UK). Postgraduate Course in Legal Translation from the University of Valencia. Specialist in Medical Translation, with several years of experience in the field of Assisted Reproduction. More information about Sandra Fernández

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