Infertility and Celiac Disease

Celiac Disease and Infertility

What is Infertility?

Infertility is the temporary or permanent inability to get pregnant. Many experts define infertility as not being able to get pregnant after at least one year of trying. Women who can get pregnant but then have repeated miscarriages are also considered to be infertile. Nearly 6.7 million women in the US have difficulty getting pregnant or carrying a baby to term. Men can also be infertile.

A few examples of potential causes of infertility include:

Endometriosis
Uterine fibroids
Low sperm count
Low testosterone
Chemotherapy

What is the Connection between Celiac Disease and Infertility?

Several studies have found conflicting results when looking at the link between celiac disease and infertility. Some studies have found that women with undiagnosed celiac disease may have issues with fertility, while others have shown that there is no increased risk of infertility. It is not known if the nutritional issues (malabsorption) that occur with untreated celiac disease may cause reproductive issues, or if the immune system may be to blame.

Celiac Disease, Infertility and Women

A 2024 research study found “a significantly higher prevalence of HLA alleles associated with” celiac disease in the group of patients with recurrent reproductive failure (69%) compared to the general population (35%–40%). In other words, those with recurrent reproductive failure are more likely to have the genes for celiac disease than the general population. What’s more, they found that a gluten-free diet improved reproductive outcomes in those with these alleles. The authors went so far as to recommend, “HLA typing for CD and a gluten-free diet, in the presence of risk alleles, can improve pregnancy outcomes in RRF patients.”
A 2016 study found the prevalence of celiac disease in women with unexplained fertility is higher than the general population.
Evidence suggests that women with undiagnosed celiac disease have an increased risk of pre-term birth and spontaneous miscarriage.
Studies have shown that women with celiac disease have an increased risk for polycystic ovarian syndrome and endometriosis.
Many celiac disease experts recommend that women with unexplained infertility be screened for celiac disease.
In the United Kingdom, the National Institute for Health and Care Excellence (NICE) recommends testing for celiac disease in women with unexplained reduced fertility or recurrent miscarriage.

Celiac Disease, Infertility and Men

Men with celiac disease may have gonadal dysfunction, which could complicate fertility issues
Semen issues (specifically sperm morphology) found in men with celiac disease improved after following a gluten-free diet
Few recent studies have been conducted on celiac disease and male infertility

Non-Celiac Gluten Sensitivity and Infertility

There is a lack of scientific information and research studies on the potential link between non-celiac gluten sensitivity (NCGS, also commonly referred to as “gluten intolerance”) and infertility. While research needs to be done, those with non-celiac gluten sensitivity are thought to possibly be at an increased risk of reproductive issues. However, the connection between NCGS and infertility is not yet known or proven. One case review did suggest that a strict gluten-free diet may improve fertility for those with NCGS.

How is Infertility Treated?

The treatment depends on the cause. Some causes are permanent and cannot be cured, whereas others can be treated, either temporarily and long enough to carry a baby to term, or permanently.

In cases where a partner has celiac disease, following a gluten-free diet may make a difference.

A 2018 study published in Human Reproduction shows how critical it is for physicians to consider undiagnosed celiac disease when a woman has reproductive problems.

The study compared the medical records of 6,319 women identified as having celiac disease through the Danish National Patient Register to the records of 63,166 women who did not have the condition. The researchers looked at the chance and timing of pregnancy, live and stillbirths, molar and ectopic pregnancy and miscarriages.

The study found that when women with celiac disease were undiagnosed, they had 11 more miscarriages per 1,000 pregnancies and 1.62 more stillbirths per 1,000 pregnancies. In the two years prior to celiac disease diagnosis, women also become pregnant less often, with 25 fewer pregnancies per 1,000. The overall risk of pregnancy problems in undiagnosed women was 15 more per 1,000 pregnancies compared to women who did not have celiac disease.

The conclusion was that undiagnosed celiac disease can lead to stillbirths and miscarriages but diagnosis makes a difference.

Where Can I Learn More?

There are many ways in which celiac disease can influence women’s health. We provide additional information in our resource: Celiac Disease and Women’s Health: A Guide to Understanding.

Additional Resources:

Do you or a family member suffer from infertility? You may have celiac disease. Find out now. Take our Celiac Disease Symptoms Checklist.

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