The celiac disease and infertility connection
With infertility on the rise, it’s time to look at the connection with celiac disease, a digestive disorder that damages the small intestine and interferes with the absorption of nutrients from food. A new study from Celiac Disease Center at Columbia University found that 6 percent of women with unexplained infertility had celiac disease. When some switched to a celiac-appropriate diet, they had healthy, successful pregnancies.
One in eight couples faces infertility, according to Resolve, the National Infertility Association. Infertility can be caused by a number of hormonal or anatomical problems in either partner, but in 20 percent of infertility cases, there’s no identifiable cause. Recent studies indicate that women with unexplained infertility may have celiac disease, which could be hampering their attempts to conceive.
Unexplained infertility: Get screened for celiac disease
When researchers at the Celiac Disease Center at Columbia University screened 188 women with infertility for celiac disease, there was no higher risk for the disorder until they narrowed that group to those with unexplained infertility. Of those, almost 6 percent had celiac disease, a rate six times higher than expected, says Alicia Woodward, editor of Living Without magazine, which reported the study.
Symptoms of celiac vary from person to person
People with celiac disease are unable to tolerate gluten, a protein in wheat, rye and barley. Switching to a strict gluten-free diet is key to managing the disease and alleviating symptoms, such as diarrhea, cramping and bloating, as well as non-gastrointestinal indications such as short stature, anemia and liver problems. Some people don’t experience any symptoms or realize they have symptoms only in hindsight.
Antibodies to tissue transglutaminase (tTg) — one of the key markers of celiac — can negatively impact placenta development. This enzyme, found throughout the body, repairs and remodels tissue and is instrumental in helping a fetus form. Abnormal tTg could directly affect a woman’s ability to sustain a pregnancy.
“Apart from strong anecdotal evidence, there’s no published research data out there yet that proves fertility improves on the gluten-free diet,” Woodward says. “For those with celiac disease, overall health dramatically improves once they go gluten free, so it is reasonable to assume that fertility would be positively impacted, as well.”
Several more studies on celiac disease and infertility are under way. At the Celiac Center at Beth Israel Deaconess Medical Center, researchers are collaborating with the fertility clinic, Boston IVF, on what will be the largest study to date on screening for celiac disease in women with unexplained infertility. The team hopes to have preliminary data in the next year.
Meanwhile, advocates are pushing for celiac screenings for women with unexplained infertility. Organizations such as the American Society for Reproductive Medicine may soon consider implementing national screening guidelines.
Naturally gluten-free whole foods include rice, soy, potatoes, beans and grains such as millet and buckwheat.
“A diagnosis of celiac disease isn’t the end of the world,” says Woodward, who recommends joining a support group for celiacs and learning as much as you can about the disease.
“It’s the beginning of taking charge of your health and improving your life.”