While there may be many reasons why women have trouble trying to conceive (TTC), one that is frequently overlooked is gluten sensitivity and undiagnosed celiac disease (CD). While results have mixed, some studies have indicated that undiagnosed celiac disease may be a risk factor for infertility (1). One such study found that undiagnosed celiac disease may be the reason for “all cause” infertility in 3.5% of women and unexplained infertility in 5.9% of women (2).
Most of the research thus far has focused on celiac disease. However some studies acknowledge a possible role of treating NCGS in the reversal of infertility (3). It has also been suggested that the same nutrient deficiencies that affect those with celiac disease (folate, iron, vitamin B12, and vitamin D) could also cause fertility problem in those with non-celiac gluten sensitivity (4).
What are the symptoms of celiac disease?
Clinical features may include:
- gastrointestinal symptoms (diarrhoea, constipation, bloating, abdominal pain, nausea, mouth ulcers)
- weight loss
- lethargy
- infertility, miscarriages and amenorrhoea
- vitamin and mineral deficiencies (vitamin B12, vitamin D, iron, folate)
- abnormal liver function tests
- early onset osteoporosis
It’s important to remember however that many people may be asymptomatic (producing or showing no symptoms) and the classical gastrointestinal symptoms mentioned above may or may not be present. Celiac disease can also present at any age, so just because you haven’t any issue in the past, you should still rule out the possibility. In fact infertility can often be the first time people realize they have a problem with gluten.
How do I find out if I have CD?
Usually your GP will screen for CD via a blood test that detects either IgA or IgG coeliac specific antibodies. Those with elevated antibodies are referred for an endoscopy to confirm diagnosis.
What about testing for non-celiac gluten sensitivity?
Firstly, celiac disease and wheat allergy should be ruled out via testing. Provided neither is detected, the best way to confirm NCGS is to undertake an elimination diet. While most symptoms tend to improve or disappear within 14 days of following a strict gluten free diet, it is necessary to persist for at least six weeks in order to be able to establish a causal relationship between a gluten-free diet and symptoms.
I am having trouble TTC, what should I do?
If you haven’t already had celiac disease ruled out, speak with your health care provider. Of course, possible gluten sensitivity or celiac disease may only be one piece of the puzzle. If you are under 35 years of age and have been TTC for 12 months, or if you are over 35 and have been TTC for 6 months, you should seek help.
If you would like help TTC naturally, find out more here.
References
- https://pubmed.ncbi.nlm.nih.gov/25003268/
- https://www.ingentaconnect.com/content/wk/jcga/2016/00000050/00000001/art00010
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4600520/
- https://www.sciencedirect.com/science/article/abs/pii/S0899900717302745