You’ve gone through a full infertility work up, done all the tests and still no conclusive reason for your inability to conceive, or to father a child, can be found. Unexplained infertility is a diagnosis that up to 25% of couples attempting to have a baby will hear in 2010. If, in addition to infertility, you also experience even mild symptoms of stomach distress, including diarrhea, stomach pain, weight loss, bloating or excessive gas, you may have a hereditary disorder called celiac disease, which most experts now acknowledge can affect reproduction as well as the gut.
According to many experts , the link between celiac and infertility is a given. While not all men and women with celiac are infertile, the incidence of celiac disease in women with unexplained infertility has been estimated at four to eight percent.
The Medical Director of Fertility Centers of Illinois, Dr. Edward Marut, said “People with celiac disease have an allergy to gliadin, which is the protein in wheat. This allergy causes stomach distress. There have been recent reports of an association between celiac disease and reproductive problems, both the inability to conceive and also, repeat miscarriages. Sometimes, especially when the condition goes untreated, the patient will present with stomach issues such as bloating, abdominal pain, and even weight loss. Sometimes an infertile patient will manifest no symptoms of celiac but upon testing, the antibodies and genes associated with the disease will be found. When dietary modifications are made, normal reproductive functioning can occur.”
Because people with celiac are often asymptomatic, the disorder often goes undiagnosed for years or even a lifetime. Whether you are a man or a woman, if you suspect that this diagnosis might be at the core of your infertility, request that your doctor run a blood test.. If you do in fact have celiac, your blood test will show higher than normal levels of some autoantibodies. These are proteins that react against the body’s own cells or tissues. Your doctor will test for tTGA, or high levels of anti-tissue transglutaminase antibodies and also EMA, or anti-endomysium antibodies. If these tests come back negative but celiac is still suspected, additional blood tests will be done.
If the tests do in fact indicate celiac, a biopsy of the small intestine will be done to confirm the diagnosis. Upon confirmation, the patient will be placed on a gluten free diet. Going gluten free is the sole treatment for celiac disease. Gluten containing foods, such as wheat, rye and barley, injure the lining of the small intestine.
In two large case control studies, as reported by celiac advocate Michelle Melin-Rogovin, researchers at the Chicago Celiac Disease program found that young women who were not on a gluten free diet began their menstrual cycle 1 1/2 years later than those who were gluten free.
39% of menstruating women who were not gluten free went for long stretches of time without a period (amenorrhea), compared with gluten free women who experienced amenorrhea at a much lower rate of 9%.
In addition, the gluten free women went into menopause an average of four to five years later than their gluten eating counterparts.
An additional finding that researchers identified was that infertile women test positive for celiac related antibodies at a rate that is ten fold higher than the normal population.
In further research studies on pregnant women with celiac, 21% experienced pregnancy loss, although some women within that statistic had previously carried a baby to term or, were able to successfully complete a pregnancy later on.
Miscarriage among women with this diagnosis is a significant concern. According to Georgia based reproductive endocrinologist, Daniel Shapiro, M.D., “It is now widely accepted that patients with recurrent pregnancy loss and an unrevealing basic work up should be offered testing for celiac disease. The first line treatment is to establish a strict gluten free diet, however, some patients will continue to miscarry even after dietary change. Although there is no guidance in the literature as to how to handle these patients, we have had some success using empiric aspirin and heparin in addition to the gluten free diet.”
Celiac disease is a serious condition which can impact an individual’s health, physical comfort and well being, independent of infertility concerns. However, it is the lack of diagnosis that creates the problems associated with the disorder. Once diagnosed, celiac is easily controlled for the vast majority of inflicted individuals through simple dietary modifications..
If you are concerned about celiac disease, speak to your doctor, and get the tests necessary to confirm the diagnosis. Then, healing can begin.
For information on the gluten free diet, as well as more information on celiac disease, visit these websites: