Fertility disorder associated with celiac disease in males and females: fact or fiction?

AIM The association between celiac disease and infertility is controversial in the literature. The aim of this study was to determine the prevalence of celiac disease among the couples with unexplained infertility. MATERIAL & METHODS Serum samples from 100 Iranian couples with unexplained infertility were evaluated for celiac disease by tissue transglutaminase antibody (tTGA). Two hundred couples not reporting reproductive problems and having delivered at least one uncomplicated birth served as controls. Total immunoglobulin A (IgA) was also obtained to investigate IgA deficiency. Those with IgA deficiency were tested with IgG tTG. Those cases with positive tTGA or tTGG (IgA deficients) underwent upper gastrointestinal endoscopy. RESULTS Positive results of tTGA were detected in 13 infertile subjects (6.5%, 6 males and 7 females) and 11 controls (2.8%, 4 males and 7 females) (P = 0.027). The odds ratio of celiac disease in unexplained infertile couples was 2.39 (95% CI: 1.15-5.01) compared with fertile couples. IgA deficiency was identified in 14 infertile cases and 11 controls. Only 5/24 tTGA-positive and 4/24 IgA-deficient infertile subjects and controls accepted to undergo duodenal mucosal biopsy. Celiac disease was confirmed by biopsy in three (1.5%) of the unexplained infertile patients. CONCLUSION The results of this study show that there is a higher seroprevalence of celiac disease in those with infertility in comparison to those with normal fertility.