Celiac disease raises the risk of pregnancy complications, but not infertility. Lead study author Nafeesa N. Dhalwani said, “Despite inconsistent findings from small studies, concern has been raised that celiac disease may cause infertility. Celiac patients should rest assured, our findings indicate that women with celiac disease do not report fertility problems more often than women without celiac disease.”
The researchers conducted a large population-based cohort study, which looked at over two million women of childbearing age in the U.K. The researchers compared rates of new clinically recorded fertility problems in women with celiac disease to the infertility rates in women without the condition. The researchers found that women with celiac disease were not any more likely to experience fertility problems, either prior or after their celiac disease diagnosis.
On the other hand, the researchers observed that infertility rates were 41 percent higher among celiac disease patients aged 25 to 29 compared to women without the disease. Dr. Dhalwani explained, “It is important to recognize that this represented only a very small increase in the number of women consulting with fertility problems — if we followed women between ages 25-29 years over a one-year period, presentation with fertility problems would occur in one of every 100 women without celiac disease, but in 1.5 of every 100 women with celiac disease. The fact that this increase was not seen in women of the same age with undiagnosed celiac disease indicates that it is unlikely to represent a biological impact of the condition on fertility. It may instead be related to heightened concern that may prompt earlier consultation if women experience delays in conception. This does, however, warrant further assessment.”
Undiagnosed celiac disease is not believed to be an underlying cause of infertility, and researchers suggest that testing for celiac disease in case of infertility is unlikely to explain the latter.
Previous studies that showed a link between infertility and celiac disease were quite small. This is the largest study of its kind, as it followed women for over 20 years.
More recent research looked at women with celiac disease and women without the condition in order to uncover an association between celiac disease and pregnancy complications. In a retrospective cohort study, women had to complete anonymous online surveys about their menstrual history, fertility, and pregnancy outcomes.
The researchers found that among the 970 women, 733 reported pregnancy at some point in their lives. Celiac disease patients were less likely to give birth after one or more pregnancy, compared to the controls. Celiac disease women were also more likely to experience spontaneous abortions and premature delivery. Lastly, women with celiac disease more often received their first menstrual cycle at a later age, compared to women without celiac disease.
Further research is required in order to determine the mechanisms behind celiac disease and pregnancy complications.