Going Gluten-FreeFebruary 16, 2011

Fertility Problem?

Sometimes deciding whether to include a new research study in our regular column, “Research Roundup,” or here in our blog, is pretty straightforward. Other times it’s a bit more complicated. A case in point? The recently published study in Fertility and Sterility entitled Latent celiac disease in reproductive performance of women. Here, Living Without's medical writer Christine Boyd describes the study, along with her thought process behind the decision to cover it:

In a nutshell, researchers looked at the prevalence of celiac antibodies in Indian women who had experienced unexplained infertility, recurrent miscarriage, stillbirth or intrauterine growth restriction (IUGR). They tested nearly 900 women for IgA anti-tissue transglutaminase, the widely used blood test to screen for celiac. Approximately 300 of the study participants were women who had normal obstetric histories included for comparison. Researchers found celiac antibodies were nearly 5 times more likely to be present in women with unexplained infertility, recurrent miscarriage and stillbirth compared to women without complications. In women with IUGR, antibodies were nearly 8 times more likely to show up. The team concluded that women experiencing unexplained infertility, recurrent miscarriage, stillbirths or IUGR could have subclinical celiac and screening should be considered.

I was struck by a potentially significant detail about the study: biopsies weren’t done. This isn’t altogether surprising since at least some of the women were pregnant at the time of the study. When a pregnant woman tests positive for celiac, she’s typically told to start the gluten-free diet immediately and to undergo a gluten challenge and biopsy to confirm the diagnosis after delivery of the baby and breastfeeding ends.

Rather, the biopsy piece didn’t sit well with me because the women were described as having “latent celiac disease” throughout the study. According to the National Institutes of Health’s (NIH) 2004 consensus statement on celiac, latent celiac is defined by positive celiac antibodies but no villous atrophy--intestinal damage characteristic of active celiac disease. How did we know these women didn’t have villous atrophy?

I reached out to the study’s lead investigator who said only that the women in the study had no symptoms suggestive of celiac. Did the team simply not distinguish between latent and asymptomatic celiac?

How much does this matter? Are women with latent celiac disease different from women with asymptomatic celiac disease? Are their experiences with infertility and pregnancy different? Should we still cover the study?

I think so.

Even if the study didn’t satisfy NIH’s definition for latent celiac disease, the research suggests reproductive problems may be the first sign of celiac, a finding that may help countless otherwise asymptomatic women reach a diagnosis and achieve a healthy pregnancy. In addition, recent studies suggest treatment with the gluten-free diet has a beneficial effect on fertility and pregnancy outcomes.

And that is news our readers can use.

Comments (10)

My mother was diagnosed with Gluten Sensitivity several years ago and as a result of it being hereditary I immediately went Gluten Free. I am 26, married 1.5 years, no kids yet (by choice) but I am aware that if one is gluten intolerant or Celiac it can definitely have negative effects on concieving; I hve a cousin who is in this boat. I work with several holistic doctors and recently did a detox: Standard Process Purification. While I was on it I did a lot of recipe hunting and ran across some info in regards to being gluten free and doing this detox to help more with the infertility problems.

Posted by: Melissa F | April 27, 2011 4:52 PM    Report this comment

Great article. I work for a Natural Fertility Informational website and we recenlty published a similar article. I just went wheat/mostly gluten free and dairy free a few weeks ago due to severe eczema, it disappeared in 2 days within cutting these out of my life. I can only image the damage done internally. Thanks so much for this great article!

Posted by: Dalene B | March 11, 2011 8:39 PM    Report this comment

i have only been completely gluten free since Dec. 25 last year. the doctors i went to for infertility were convinced that i was anorexic or an athlete(neither is true), i went through having an MRI, tons of blood tests(very painful since they can never find my veins and my blood moves so slow), and also other tests done that is extremely not fun for someone who is 17. finally, after all the tests i diagnosed myself after i started having more classic celiac symptoms(doctors diagnosed that as being heartburn & didn't even listen to my other symptoms) and now i have solved my infertility issues, the infertility has gone away(as far as i know).

Posted by: megan h | March 4, 2011 2:20 PM    Report this comment

i would like to know if anyone having ciliac and also has diabeties. I would love to talk to some one about having both. for years i was diagnosed with a digestive disorder caused from the diabeties. then last year i found out i had ciliac. The dr (a specialist) told me i had always had ciliac and not gastroperisies that i had been being treated for all those years. My weight is way up. I have gained 20 more pounds in the last 3 months. No mater how hard i try. I cant lose anything. My feet are a real sorse of trouble, i love to walk and tredmill. But they bust open so much i cant do anything. does anyone have this problem. mama8usa@yahoo.com

Posted by: Joyce H | February 28, 2011 12:54 PM    Report this comment

What about males with celiac?

Posted by: Unknown | February 25, 2011 9:29 PM    Report this comment

What about males with celiac?

Posted by: Unknown | February 25, 2011 9:29 PM    Report this comment

Thank you for posting this info. I was diagnosed with celiac 10 years ago. At the time, my children & grandchildren were tested and all test results were negative. I know that a person with celiac may not have any symptoms, so I have forwarded this article to my granddaughter who is try to conceive and not having any luck.

Posted by: Beverly W | February 18, 2011 1:22 PM    Report this comment

I was diagnosed with celiac in June of 2010 at the age of 45. Never having children, I experienced unexplained infertility. I am wondering now if this is why.

Posted by: Janelle M | February 18, 2011 11:09 AM    Report this comment

I've had several miscarriages and was diagnosed with heterozygous MTHFR gene mutation as the culprit. The other culprit could also be PCOS &/or the luteal phase is defective and therefore I've not been able to carry full-term. I never considered that the diagnosis of Celiac would lead me to a different option for the miscarriages. I haven't gotten pregnant while being gluten-free yet, but I'm hoping so. I only had the blood test and not the biopsy, since my doctor wasn't convinced my numbers were high enough because I had been gluten-free for over 3 weeks. He didn't put in my records anything about Celiac. I was told by a well-meaning family member that those on a gluten-free diet have difficulty conceiving, however I believe if I hadn't gone gluten-free I wouldn't be able to conceive again.

Posted by: Unknown | February 17, 2011 10:49 AM    Report this comment

My sister had several miscarriages in the 80's before a naturapath told her she had a high level of acidity in her body and put her on a macrobiotic diet. She got pregnant 3 months later and had a normal pregnancy. She has never tested for Celiac but I had a positive diagnosis 2 years ago - I am convinced it was Celiac that caused her problems back then and the macrobiotic diet 'accidently' worked for her. xabbar

Posted by: Barbara R | February 17, 2011 9:11 AM    Report this comment

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