Celiac Disease and Infertility

Trying month after month to get pregnant can be frustrating and heartbreaking, but does celiac disease have any impact on infertility?

According to the U.S. Department of Health & Human Services, out of 100 couples, approximately 13 of them will have some complications while trying to conceive. Celiac disease, especially when undiagnosed, is known to be a culprit of reproductive issues like infertility.

Infertility and celiac disease connection

Some studies have found that there is a link between women with undiagnosed celiac disease and infertility. The reason behind this is not exactly known. However, a hypothesis is that nutritional issues like malabsorption common with celiac could cause fertility issues. Another cause could be the immune system. According to the NCBI, infertility may be caused by “immune-mediated mechanisms or nutrient deficiency” in women with celiac disease. It’s been found that once a gluten-free diet is 100 percent followed, the chances of a successful pregnancy go up, as long as there are no other underlying factors.

Celiac disease could cause folic acid, selenium and zinc deficiency. Each of those vitamins are vital, especially during child-bearing years. Click here to learn more about the nutrients needed and how to make sure you are getting enough of them.

“Chronic inflammation and/our malnourishment in the mother may be poorly conducive to successful pregnancy. In addition, laboratory studies have shown that the antibody in celiac disease [tissue transglutaminase] may bind to placenta cells and cause harm,” said Benjamin Lebwohl, M.D., M.S., director of clinical research at The Celiac Disease Center at Columbia University.

Undiagnosed vs. diagnosed celiac disease

The risks associated with pregnancy are different before and after a celiac diagnosis.

“Most of the issues that have been described regarding pregnancy outcomes in celiac disease have been found in undiagnosed celiac disease,” said Lebwohl. “That is to say, patients with undiagnosed [and therefore untreated] celiac disease appear to have an increased risk of outcomes such as miscarriages or difficulty conceiving.”

Prior to celiac diagnosis and treatment, women had an increased risk for spontaneous abortion or stillbirth.

The data came from the entire population of Danish women between 1977 and 2016. The analysis included 6,319 women diagnosed with celiac who had follow-up records in the health registry. After diagnosis, they were just as likely to become pregnant as women in the general population. They had no more problems during pregnancy and childbirth.

In contrast, women with celiac had fewer pregnancies than average during the two years prior to diagnosis. Overall, women with undiagnosed celiac had 11 more miscarriages and 1.62 more stillbirths per 1,000 live births. This supports a focus on early diagnosis in women, especially those who lose pregnancies. Following diagnosis, the risk changes.

“In those with diagnosed celiac disease who have already started the gluten-free diet, the risk largely goes away,” Lebwohl said.  

The key to a pregnancy with celiac—and is the key to the disease in general—is adherence to the gluten-free diet and consistent follow-up care. “It is important to stick to a strict gluten-free diet prior to and during pregnancy, and to be up to date with routine celiac antibody and nutrient checks,” Lebwohl said. 

Learn about the basic gluten-free diet here.

Menstrual cycle issues

Some reasons for infertility is issues with menstrual cycles. Some women find they miss a period altogether. Undiagnosed celiac disease can lead to missed periods. However, once a gluten-free diet is introduced, a menstrual cycle should continue if the diet was the only issue.

Infertility symptoms

If you have been trying for one year or more with no success of conceiving, it’s time to talk with your doctor. Women over 35 years old should seek medical advice after six months of trying. Additionally, there are multiple common signs of infertility to keep in mind.

  • Irregular periods
  • Heavy or painful periods
  • Reduced sex drive
  • Hormone fluctuations
  • Weight gain
  • Facial hair growth
  • Thinning hair

If you’re experiencing infertility, don’t hesitate to reach out to your doctor. Be sure to follow your gluten-free diet or get a diagnosis if you suspect you may have celiac disease, and explore other issues that could be a contributing factor. To learn more about how celiac disease impacts pregnancy, click here.

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