Recently a few patients have asked me about celiac disease, gluten and infertility, so I decided to just write a few words about it. Celiac disease, also known as gluten-sensitive enteropathy, is a chronic disorder of the digestive tract in which individuals cannot tolerate gliadin, which is a component of gluten and can be found in wheat, barley and rye. Gliadin actually gives bread the ability to rise properly during baking. When gliadin is ingested by someone with celiac disease, it causes an immunologically-mediated inflammatory response, which damages the lining of the intestine, which then leads to abnormal digestion and absorption of nutrients. Interestingly, celiac disease is slightly more prevalent in women than men and there is about a 10% prevalence of the disease in first-degree relatives.
So does celiac disease affect fertility?…the jury is still out
Well, a good amount of studies now suggest a higher incidence of celiac disease in patients with infertility such as a recent meta-analysis in the Journal of Clinical Gastroenterology (Singh et. Al, 1/2015) while there are still some other studies refuting that. So the jury is still out on that and there are no clear guidelines or recommendations whether or not to test patients dealing with infertility for the disease or start them on a gluten-free diet. However, it does not hurt to keep celiac disease and possibly a gluten-free diet in mind when evaluating patients for fertility.