Hidden Cause of Infertility: Undiagnosed Celiac Disease

By: Lori Waters, Medical Awareness Coordinator-

Edmonton Chapter, Canadian Celiac Association

When there appear to be no medical explanations for your infertility, visits to the doctor can be incredibly depressing. While there can be situations where no medical reasons can be found, this is not always the case. In some circumstances there may be an underlying, silent cause that your doctor is missing: that is the case with Celiac Disease

Celiac Disease (CD) is a medical condition in which the absorptive surface of the small intestine is damaged by ingestion of gluten. Once damaged, the small intestine inhibits the body’s ability to absorb nutrients: protein, fat, carbohydrates, vitamins and minerals, all of which are necessary for good health.

Patients with CD typically present with unexplained anemia, chronic diarrhea, weight loss, fatigue, cramps and bloating. The ambiguity of these symptoms can make CD a difficult case to diagnose. In addition, CD has been known to manifest itself in various other asymptomatic forms, such as miscarriages and infertility.

Initially, CD may be suspected from finding persistent iron deficiencies and abnormal weight loss during a pregnancy. A body with the inability to absorb nutrients is likely to have problems carrying a baby to term. Further, research suggests that women with undiagnosed CD have up to 8.9-fold relative risk of multiple abortions and low birth weight babies compared with treated patients . In the same study, six babies were stillborn in an undiagnosed group compared with none in a group on a gluten free diet . Thus, undiagnosed and untreated CD is a factor in carrying a baby to term.

In addition, findings are now showing that undiagnosed CD might inhibit getting pregnant. One study found that the prevalence of CD in infertile women is higher (three out of 99 or 3.03%) than in the general population (17 out of 1607 or 1.06%). In this study, the numbers were particularly high in the subgroup of women with unexplained infertility (two out of 25 or 8%).

CD is the fastest growing under-diagnosed disease of Caucasians. The average length of time for diagnosis is an unacceptable 11 years and more than one physician has to be consulted prior to diagnosis. It is now estimated that 1/133 North Americans have CD, and for every one diagnosed many are left undiagnosed. . It is important to note that CD is not screened for when seeking to determine the cause of infertility and, unlike most screened conditions, it is easily treatable.

CD is diagnosed by a relatively straightforward two stage process. First, CD can be eliminated by a simple blood test. If the blood test is positive a small bowel biopsy must be performed for a definitive diagnosis. The biopsy must take place before treatment starts.

The treatment for CD is a gluten-free diet for life. It involves eliminating all sources of wheat, rye, oats and barley from one’s diet. The diet can be difficult to follow because some sources of gluten are hard to determine; however, once diagnosed and treated, CD no longer becomes a factor in infertility.

While your infertility may not be linked to CD a simple blood test can rule it out. Ask your doctor to consider Celiac today. For more information on Celiac Disease visit the Canadian Celiac Association Web site at www.celiac.ca or phone the office toll free at 1-800-363-7296.

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