Celiac Disease and Infertility

Breaking the Silence: Uncovering the Link Between Celiac Disease and Infertility

Testing for genetic markers has become one of the newest ways to help diagnose celiac disease. As celiac disease is an autoimmune condition, its effects on the body can be damaging in many ways. 

Some studies show a correlation between people with untreated celiac disease and infertility, particularly unexplained infertility. Studies also show a link between autoimmune conditions in general and fertility problems. 

With a 99% negative predictive value, celiac genetic risk testing is an easy first step for ruling out suspected cases of celiac disease.

Causes of Infertility

A study from 2013 found that 11% of women and 9% of men report having experienced fertility problems. After one year of trying to conceive, around 11-15% of couples have not been successful. 

There are many health conditions, environmental factors, dietary issues, and social reasons why infertility occurs. For people trying to conceive, remaining in the best health possible and maintaining a healthy lifestyle is vital to conceiving naturally or through fertility treatments. A proactive approach includes looking into any potential health problems they may be overlooking.

As an autoimmune condition, celiac disease affects the whole body. There are many ways that celiac disease interferes with our nutrition, health, and fertility. 

causes of infertility

Celiac Disease Infertility

In people with celiac disease, gluten causes a notable change to the wall of the small intestine. Small finger-like protrusions cover the lining of the small intestine. These protrusions move around and absorb nutrients from the food we eat. 

This process is how we stay nourished and healthy. When a person with celiac eats gluten, these protrusions become swollen and flat, unable to absorb nutrients from food, and often begin to let water into the gut, causing malabsorption and diarrhea.

Nutritional deficiencies

Keeping our body in good health for fertility requires us to stay well nourished. As our bodies are built with survival as our primary goal, when we are malnourished, our body prioritizes the systems of the body that keep us alive. We can only procreate if we are still alive, so our body will sacrifice nutrients for our reproductive health to keep us in better physical condition. 

Hormonal imbalances

Celiac disease can affect our hormone levels. These imbalances can affect our menstrual cycle and fertility. 

Hormonal imbalances can affect our fertility in many ways. 

  • Polycystic Ovarian Syndrome
  • Heavy or painful periods
  • Absent periods
  • Symptoms of too much or too little estrogen, progesterone, and testosterone
  • Stopping or inconsistent ovulation
  • Producing low-quality or quantity sperm

Inflammation

As an autoimmune condition, celiac disease can cause inflammation throughout the body. Studies show that evidence of inflammation appears more frequently in people suffering from infertility problems. 

The mechanisms of how inflammation creates hormonal imbalances and fertility problems are not yet fully understood, but the correlation is becoming clear. 

Symptoms of Celiac Disease Infertility

Unexplained infertility often has very few symptoms but sometimes there are some clues that all may not be well in the reproductive system. 

Abnormal menstrual cycle

Due to affected hormone levels, people with celiac disease can see changes in their menstrual cycle. Experiencing missed or heavier periods than normal can be a sign of hormonal imbalances in the body. 

Premenstrual syndrome

Low sperm count

When we raise the subject of infertility, people’s thoughts often drift to problems for women. While it is true that many infertility issues surround the female reproductive system, an equal amount are the result of male sperm quality and quantity issues. 

Studies show a potential link between untreated celiac disease and men with infertile marriages showing abnormalities in sperm motility and morphology. 

Low libido

An unexplained low libido can signal that hormones are not currently in balance. In both men and women, libido is linked directly to our hormone levels. For some people, low libido is their first and only symptom of hormone imbalances. Celiac disease is one of many issues that can create imbalances that lead to low libido. 

Diagnosing Celiac Disease Infertility

If you suspect you may have symptoms of celiac disease, testing can diagnose or rule out the disease and begin the journey of diagnosing and healing the underlying problem. 

Genetic testing

One newest innovative testing procedure for celiac disease is testing for the genetic markers for celiac disease. Some gene mutations are associated with celiac disease. Testing whether you carry one or more of these genetic mutations allows you to see your likely chances of developing celiac disease. With a >99% predictive value, genetic celiac disease testing is an easy first step for suspected cases of celiac disease. 

Genetic tests are available both through your physician or at-home testing services. Targeted Genomics provides convenient, affordable, and private, at-home celiac disease genetic testing kits, providing you with your GlutenID. With a simple cheek swab and no invasive procedure, you can see whether you have any known genetic mutations associated with celiac disease. 

Genetic testing is accurate whether or not you are eating gluten. It does not look at symptoms or changes in the blood, only at your genetic makeup, which never changes even when you stop eating gluten. 

Genetic test

Blood tests

A traditional testing solution for celiac disease is blood testing for antibodies to gluten. People with celiac disease can often have a positive blood test and then move on to a biopsy procedure to confirm that it is the case. 

For a good number of people, the blood tests are not fully reliable, and if symptoms are particularly suspect for celiac disease, biopsies and genetic testing, in addition to blood testing are recommended. 

Small Intestine Biopsy

By undergoing an endoscopy and biopsy procedure, it is possible to see the effects of celiac disease and confirm a diagnosis. 

Because celiac disease is an autoimmune condition, it can evade diagnosis for long periods. Many people with celiac disease have at least one test showing negative results for the disease.

Having several ways to test for celiac disease while carefully tracking symptoms is vital to catching the celiac disease in action. 

Treatment of Celiac Disease Infertility

Treatment of celiac disease involves both stopping continued damage to the body from gluten and repairing and restoring the body after celiac disease damage. The treatment of celiac disease involves more than simply giving up pasta and bread. 

Celiac Disease Infertility

Dietary changes

Keeping a strict gluten-free diet is the most critical change for stopping and reversing malnutrition and damage caused by celiac disease. The recommended gluten-free diet for celiac disease is a strict gluten-free diet. This goes further than skipping bread and pasta and involves reading labels closely and becoming familiar with gluten-free labels and signage.

Vitamin and mineral supplements

Many people with celiac disease are undiagnosed for a long time. During that time, some damage often occurs, and inflammation is rife in the body. 

Changing to a gluten-free diet helps to stop further damage and dramatically reduce damage previously done by gluten. For some people, the reduced absorption of vitamins and minerals from food is a permanent feature. 

One way to combat this lower absorption rate is to supplement vital vitamins and minerals into your routine. Supplementation helps keep the body nourished and provides peak amounts of nutrients for fertility purposes and pregnancy. 

Supplements

Fertility treatments

For some people with infertility, treating their celiac disease restores their body to better health, but still requires fertility treatments to achieve pregnancy. This is the case for many people suffering from infertility for any reason. Staying healthy with nutrients helps to improve the chances of successful conception both naturally and through fertility treatments. 

Risk Factors for Celiac Disease Infertility

Some people are more at risk for developing silent or symptomatic celiac disease than others. Genetic factors are responsible for the likelihood of developing the disease. Once diagnosed, there are some ongoing risk factors for infertility in people with celiac disease. 

Family history of celiac disease

Celiac disease is an autoimmune disorder that is hereditary in its origin. Genes for developing celiac disease are passed down from parents to children, even when the parent does not develop the disease themselves. 

If you have family members with celiac disease diagnosis or symptoms, checking your genetic risk allows you to see your chances of developing the disease. 

Autoimmune disorders

Celiac disease is an autoimmune disorder and not an allergy. It can affect the body in many ways, showing up as gastrointestinal problems, fatigue, anemia, skin rashes, hair loss, weight loss or gain, headaches, and pain. 

People suffering from one autoimmune disorder have a higher chance of developing an additional one in their lifetime.

 Many autoimmune disorders can cause infertility. For people with a preexisting autoimmune illness that have or suspect they have celiac disease, the chances of autoimmune disease-related infertility are higher. 

Eating a gluten-free diet

Sometimes when people start to eat a gluten-free diet, they don’t realize that they are removing many nutrients from their diet. Most manufacturers of gluten-containing flours, cereals, and pasta products in the United States enrich their products with nutrients like iron, folate, and B12. These are all important nutrients for our health and are vital for fertility and pregnancy. 

Switching to a gluten-free diet without taking note of how many nutrients you are taking in can lead to continued malnourishment, which affects fertility and pregnancy outcomes. 

Conclusion

Although research is not vast on the array of symptoms of celiac disease, several studies show potential links between untreated celiac disease and fertility problems in both men and women. 

Infertility is a problem for so many couples. None is more frustrating than unexplained infertility. With the testing options available, including at-home genetic celiac disease testing, people suspicious about or interested in their potential for developing the disease have a variety of options to explore. If you suspect you are suffering from symptoms of celiac disease, do not hesitate to see your doctor.

Celiac disease is an autoimmune disease. We must remember that celiac disease is not an allergy. It can, along with other autoimmune diseases, affect the whole body, including our hormonal and reproductive systems. Knowing your GlutenID is a proactive step in ensuring your health and fertility remain free from the damage from silent celiac disease. 

Picture of Shelly Gunn MD, PhD

Shelly Gunn MD, PhD

Dr. Gunn is a board certified clinical pathologist and director of PacificDx molecular laboratory since 2015. Dr. Gunn has dedicated her career to the analysis of specific genes as root causes of disease and response to therapy. She has served on the faculty of the UT Health Department of Pathology and is the author of several peer reviewed articles on. molecular diagnostics.

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Breaking the Silence: Uncovering the Link Between Celiac Disease and Infertility
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