The link between coeliac disease and infertility

Some people believe and have argued that eating a gluten free diet favours a positive result in people who are having assisted reproduction treatment. However, data provided by the IVI-RMANJ group, a global leader in assisted reproduction, has shown that this is nothing more than a myth. Non-coeliac patients who adopt a gluten free diet obtain the same success rates in assisted reproduction treatment as those who continue to eat food containing gluten. 

Numerous studies on women suffering from unexplained infertility suggest that coeliac disease can be a factor in the inability to get pregnant. In fact, some clinicians advocate testing all women who are suffering from unexplained infertility for coeliac disease. Many women only discover they have coeliac disease at this moment in their life. 

Pregnancy complications in undiagnosed and untreated coeliac disease have been linked to vitamin and mineral deficiencies caused by malabsorption of nutrients due to the damage done to the intestinal mucosa. Transglutaminase antibodies produced by the immune system in coeliac disease are also believed to have an impact on implantation and the survival of a pregnancy.  

However, these complications, such as low weight of babies at birth, appears to be an effect of coeliac disease symptoms being out of control, notably malabsorption of nutrients due to intestinal damage and antibodies produced by the body’s autoimmune reaction to gluten. 

Coeliac disease has long been thought to play a role in fertility problems for women patients, but there is increasing evidence that coeliac disease that is being properly treated with a strict gluten free diet does not have much of an impact. 

A recent study by the UK’s Nottingham University found that women with coeliac disease were, in general, no more likely than women in the general population to report fertility problems. A slight exception was found with the group of women diagnosed with coeliac disease and aged between 25 and 29 years old, who were 41% more likely to encounter fertility problems than with their non-coeliac peers.  

In effect, this means that for women in the 25-29 age group over a given year, one in 100 without coeliac disease would report a fertility problem, compared to 1.5 in every 100 women with coeliac disease. 

If the amount of research into coeliac women and fertility is scarce, with men it is even less abundant. However, the data that has been examined suggests that men with coeliac disease could be more likely to have gonadal dysfunction, which could cause fertility problems.  

However, studies have shown that issues with sperm morphology, sperm count and motility all improved when men treated their coeliac condition with a gluten free diet. More research is needed to confirm these possible findings.   

Some people do not have coeliac disease with the associated damage to the intestine, and yet they have an intolerance to gluten that produces the same experienced symptoms as coeliac disease, including stomach cramping, diarrhoea, bloating and many others. At this time, no adequate studies are available on whether some of the fertility issues related to coeliac disease also apply to non-coeliac patients with gluten sensitivity.