As researchers study the effects of Gluten on your fertility, it becomes easier to understand how Celiac disease causes infertility. In many patients, infertility caused by Gluten sensitivity is simply labeled as unexplained infertility, and couples end up undertaking fertility treatments that they probably don’t need.  

Infertility due to Gluten-sensitivity is more common than you think. Gluten was found to be the causative factor in almost 6 percent of the patients of unexplained infertility (1).

Celiac disease infertility

Understanding the connection between Celiac disease and infertility is crucial for the effective management of both conditions, especially before you jump into expensive treatments like IVF.

What is Celiac disease?

Celiac disease is a chronic autoimmune disorder characterized by an abnormal immune response to gluten, a protein found in wheat, barley, and rye.

Gluten is a binding protein that helps glue carbohydrates together. Normally the body breaks down the gluten, and moves it through the digestive tract. With gluten sensitivity, however, the body mounts an immune response to the gluten itself, which causes inflammation, irritation and possible tissue breakdown along the digestive tract. 

As a byproduct of the immune reaction, the body secretes inflammatory chemicals that can cause fatigue, anemia, joint pain, skin problems, and neurological issues.

How does Celiac disease cause infertility?

According to a study published in the Human Reproduction journal (2), Celiac disease can cause of infertility through various mechanisms as below:

  1. Malnutrition: In people with Celiac Disease, Gluten consumption causes intestinal damage that halts the absorption of nutrients. This results in malnutrition, which then leads to fertility problems as obviously, a malnourished body is not fit to carry a pregnancy. Even if she conceives, a malnourished pregnant woman faces increased risk of miscarriage.
  2. Hormonal problems: Malnutrition alters the normal balance of nutrients like Zinc, Calcium, Selenium, Iron, and Vitamin D, which is important for signalling the production of ovulation-managing hormones like LH and FSH, DNA, and oxygenation. 
  3. Chronic inflammation: Inflammation and immune system dysfunction in Celiac disease can disrupt hormonal balance, affecting the menstrual cycle, and ovulation in women, and spermatogenesis in men. It can also impact gamete quality and embryo implantation.
  4. Lifestyle factors: Celiac Disease presents different symptoms causing people to adjust their lifestyles in ways that possibly make it hard for them to conceive. People have less intercourse due to pain, discomfort, bloating, diarrhea, joint pain, and chronic fatigue, thus reducing their chances of conceiving.

According to the Gluten Free Society (3), pelvic inflammatory disorders (PID) and polycystic ovarian syndrome (PCOS)—the two most common causes of infertility—are both linked to Gluten sensitivity in women.

Can Celiac disease affect your periods?

Women with Celiac disease, commonly have problematic periods, suggesting some possible connection to infertility.

In an Italian study (4), nearly 20% of the women with Celiac disease were found to have amenorrhea (missed menstrual cycles) as compared to only 2.2% of those who didn’t have Celiac.

Can Celiac disease affect male fertility?

Although research into the effects on women is more established, studies also suggest a connection to male infertility—from difficulty with conception to low sperm count and poor sperm motility.

Italian researchers have noted that male patients with Celiac disease have a greater risk of infertility and other reproductive issues, as well as a greater incidence of androgen (male hormone) deficiency (5).

Additionally, Celiac disease causes an increased risk of erectile dysfunction, which can further reduce the chances of successful conception.

You can get shock-wave therapy for erectile dysfunction in Thailand, but infertility will be resolved only after improving your Celiac disease.

Can Celiac infertility be reversed with diet?

Yes, a gluten-free diet and lifestyle change can improve your fertility significantly.

Gluten free diet for pregnancy

A large Swedish study of 11,000 women found that fertility was reduced in the two years preceding the diagnosis of Celiac disease and returned to normal ranges after it was treated (6).

A number of European studies (7) also pointed that women who had multiple IVF failures should be tested for Celiac disease, and if they test positive, conception would be possible by adopting a Gluten-free diet.

How to treat infertility due to Gluten sensitivity?

If you have infertility due to gluten intolerance or are wondering if you can get pregnant with Celiac disease, your first step should be to find a good fertility specialist who understands gluten and infertility.

This is particularly important if you have digestive problems and have been diagnosed with unexplained infertility.

Next, make sure your body is ready for pregnancy. This includes ensuring your diet is optimized, any other health problems (like diabetes) are under control before trying to conceive.

It’s important to keep in mind that Celiac disease itself doesn’t cause infertility it just makes it more difficult for the body to get or stay pregnant.

Can Gluten-free diet help you get pregnant?

Researchers in the UK presented a report (8) based on studying the experiences of women diagnosed with infertility, investigating the potential role of gluten, including testing and implementation of a gluten-free diet (GFD).

Both intestinal and extraintestinal symptoms were seen in infertile women, which were remarkably improved after following a GFD. 

Many participants were not offered proper testing by their healthcare practitioners despite experiencing symptoms associated with Celiac disease and non-celiac Gluten sensitivity (NCGS), raising concerns about medical inertia and a lack of awareness amongst healthcare professionals.

Ongoing nutrition care may be supportive for if you’re facing infertility due to Celiac disease and it may help improve your overall health as well as fertility status.

Celiac disease can cause infertility. If you need a consultation with an IVF expert for infertility due to Gluten sensitivity, get in touch using the red contact button on this page.
References
  1. Choi, J. M., Lebwohl, B., Wang, J., Lee, S. K., Murray, J. A., Sauer, M. V., & Green, P. H. (2011). Increased prevalence of celiac disease in patients with unexplained infertility in the United States. The Journal of reproductive medicine56(5-6), 199–203. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3122153/
  2. L Grode, B H Bech, O Plana-Ripoll, M Bliddal, I E Agerholm, P Humaidan, C H Ramlau-Hansen, Reproductive life in women with celiac disease; a nationwide, population-based matched cohort study, Human Reproduction, Volume 33, Issue 8, August 2018, Pages 1538–1547, https://doi.org/10.1093/humrep/dey214
  3. Gluten Free Society Blog; Gluten Intolerance Causes Infertility https://www.glutenfreesociety.org/gluten-intolerance-causes-infertility/
  4. Martinelli, D., Fortunato, F., Tafuri, S. et al. Reproductive life disorders in Italian celiac women. A case-control study. BMC Gastroenterol 10, 89 (2010). https://doi.org/10.1186/1471-230X-10-89
  5. Freeman H. J. (2010). Reproductive changes associated with celiac disease. World journal of gastroenterology16(46), 5810–5814. https://doi.org/10.3748/wjg.v16.i46.5810
  6. Butler MM, Kenny LC, McCarthy FP. Coeliac disease and pregnancy outcomes. Obstetric Medicine. 2011;4(3):95-98. doi:10.1258/om.2011.110007
  7. Shah, S., & Leffler, D. (2010). Celiac disease: an underappreciated issue in women’s health. Women’s health (London, England)6(5), 753–766. https://doi.org/10.2217/whe.10.57
  8. Justine Bold, Dimitra Diamantopoulou. Views and experiences of infertile women regarding the role of gluten in their infertility. Obstetrics and Gynecology Research 5 (2022): 296-310 https://www.fortunejournals.com/articles/views-and-experiences-of-infertile-women-regarding-the-role-of-gluten-in-their-infertility.html

Reviewd by: Dr. Meenakshi, PhD

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