Infertility in Celiac Patients

It was about a year and a half ago when I announced to the world that I was pregnant. It took us all by surprise and yet what a wonderful journey it has been. But it really caused me to ponder how my body works. I had never been on birth control and yet for 10 years after my second child was born, there were no pregnancies. How fascinating, that after my husband and I entered a world of gluten free living, and for the past 3 years have allowed our bodies to heal from the damage and inflammation that gluten intolerance and celiac can cause, we became pregnant. Well, I did anyway, although at times I really wish I could have put some of the nausea on him! But it really peaked my interest because, as you might recall in some of my previous articles, I mention infertility as a definite symptom in celiac disease. So why is it that fertility specialist don’t add this as a route to take when dealing with infertility issues? A study in the medical journal Human Reproduction identified gluten sensitivity in as many as 8% of women with unexplained fertility problems. Other studies have found celiac disease rates of about 4% in women with unexplained infertility. In one study, which found four cases of celiac disease in a group of 98 women with unexplained infertility, none of the celiac women had extensive malabsorption, but two suffered from iron deficiency anemia.
It is not yet clear as to why more people with undiagnosed or untreated celiac disease suffer from infertility. It’s possible that malnutrition resulting from malabsorption of nutrients in your food may be to blame, or there may be some yet-undiscovered reason.
The following conditions are known to contribute to fertility issues in both men and women. They are also linked to gluten sensitivity:
• PCOS – poly cystic ovarian syndrome
• Diabetes
• Amenorrhea (absence of menstrual cycle)
• Hypothyroidism
• Disorders of the endocrine system
• Nutrient malabsorption, especially iron
• Nutritional deficiencies
• Irritable bowel syndrome (IBS)
• Inflammatory bowel disease
• Intrauterine growth retardation
• Spontaneous abortion
• Multiple miscarriages
• pregnancy-related hypertension
• Low sperm count in men
• Low sperm motility
• Abnormal sperm shape
• Androgen (male hormone) deficiency
One study, published online in the Journal of Obstetrics and Gynecology Research, looked at the prevalence of celiac disease among couples with unexplained fertility in Iran.
The researchers obtained blood samples from 100 Iranian couples with unexplained infertility in order to test their blood for tissue transglutaminase (tTG-IGA) a blood antibody marker in celiac patients.
The study also looked for IgA deficiency in subjects, since that can cause false negative blood test results. IgA deficiency is much more common in people with celiac disease than it is in the general population.
In addition to the 100 infertile couples, the researchers also tested 200 couples not reporting fertility problems with at least one child as a control group. In addition, anyone with positive blood test results underwent endoscopy and a biopsy to determine if there was villous atrophy present.
Thirteen infertile subjects had positive blood test results, compared to 11 controls, meaning that more than twice as many infertile people had positive celiac blood test results when compared to the control group. In addition, IgA deficiency was identified in 14 people with infertility and 11 controls.
Only five of the 24 people with positive blood test results and four of the 24 people with IgA deficiency opted to undergo an endoscopy and biopsy, and celiac disease was confirmed in three of the unexplained infertile patients. These results are promising, in that the presence of infertility in celiac patients, usually undiagnosed and hence not yet following a gluten free diet, are very real.
If you are having any of these symptoms and you are trying to get pregnant, check with your doctor about being screened for gluten sensitivity or just follow my plan for a gluten free life style. Remember to be patient. For some it may be 40+ years that you have been eating gluten. It will take some time for your body to heal. I guess in my case, the magic number was 16 months.
Source: Human Reproduction; 14(11):2759-61 1999

Macaroni and Cheese
Ingredients:
1 package of gluten free pasta
½ cup sour cream
1 cup plain rice milk
1 T arrowroot
8 oz. shredded jack/chedder blended cheese
1 T butter
½ cup crushed gluten free corn flakes
Directions:
Cook Past in boiling water for 9 minutes.
Drain and set aside.
In small bowl mix arrowroot with milk. Add to butter and cook stirring constantly to thicken.
Add cheese to sauce and cook slowly to melt.
Add sour cream.
Add salt to salt.
Combine sauce with pasta and cover top with crush with corn flakes.
Bake at 350 degrees for 30 minutes.
Serves 6.

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