Fertility Recent research carried out by Dr Joe West and his team at Nottingham University has looked at the relationship between coeliac disease and fertility. This is because you are not absorbing these nutrients from food because of the damage to the lining of your gut. These nutrients are all essential for a healthy reproductive life.
However, some studies have shown that people with untreated coeliac disease and unexplained infertility did not show any signs of nutrient deficiency. This suggests that infertility cannot be explained simply by being deficient in certain nutrients and other factors must be involved. Coeliac antibodies that are produced in untreated coeliac disease can have a negative influence during the early stages of pregnancy. Women with coeliac disease may be fertile for a shorter period of time because they may start their periods later and have an earlier menopause.
This may be related to altered hormonal levels or because women with undiagnosed coeliac disease can have a lower body mass index. More research is required to confirm any of these theories. Pregnancy complications and birth outcomes Women diagnosed with coeliac disease on a gluten free diet did not have an increased risk of pregnancy complications haemorrhage, pre-eclampsia and mode of delivery or adverse birth outcomes preterm birth, still birth and low birth weight compared to women without coeliac disease.
Congenital anomalies Congenital anomalies, also known as birth defects, can occur during the development of the baby in the uterus. Getting tested for coeliac disease It is recommended that anyone with unexplained subfertility below normal levels of fertility or recurrent miscarriage is offered a blood test for coeliac disease, even if there are no other symptoms present.
If you are diagnosed with coeliac disease, the treatment is a lifelong gluten free diet. CD can cause zinc, selenium, and folic acid deficiency, which are all important compounds for pregnancy. The authors looked to how the immune system of female CD patients could affect their pregnancy. They proposed two possibilities: the first that anti-transglutaminase tTG antibodies bind to the trophoblast layer of the embryo, causing damage to the future placenta, and the second that anti-tTG antibodies can harm the cytoskeleton of the endometrial endothelial cells of the mother.
More studies are needed to further elucidate the mechanism between untreated CD and reproductive health. The authors admit to some limitations in their study. This article still shows that CD has serious implications for pregnant women, but fortunately, treatment with a gluten-free diet should relieve most of their worries.
The study this article is based on can be found here. It can present with gastrointestinal symptoms such as diarrhea, bloating or weight loss. However, only about one-quarter of patients present with these classic malabsorptive type of symptoms.
Many patients present with only one symptom, and a quarter of patients might have no gastrointestinal symptoms and only extra-intestinal symptoms such as anemia, osteopenia, chronic fatigue or arthralgia joint pain. Moleski : The pathogenesis of pregnancy complications in celiac patients has been linked to vitamin and mineral deficiencies of zinc, selenium, iron and folate.
The inflammation which occurs in the small intestines with untreated celiac disease leads to malabsorption of these vitamins, which can then disrupt hormones and lead to pregnancy complications. It has also been suggested that placental tTG an enzyme linked to celiac disease may be bound by a maternal antibody to tTG, which may adversely affect placental function. Q Did the women in your study with confirmed celiac disease experience pregnancy complications before diagnosis and before starting a strict gluten-free diet?
Moleski : Most of the women did experience complications before starting a gluten-free diet. Other studies have shown that once women are on a gluten-free diet, their pregnancy outcomes normalize.
An Italian study Ciacci et al found that women who were undiagnosed with celiac disease and not on a gluten-free diet had a higher risk of miscarriage compared to women with celiac disease who were already on the diet. If you think celiac disease could be responsible for your recurrent miscarriages, talk to your healthcare provider about testing for the condition. Vitamins and minerals are an important building block for health, and this is especially important when trying to conceive and during pregnancy.
Because celiac disease disrupts the small intestine's function, it can interfere with fertility and fetal development which can in turn lead to miscarriage. Celiac disease is a life-long condition, and this will not change with pregnancy.
If you have celiac disease and are expecting a child, it is important to manage your condition. Maintain a gluten-free diet to avoid intestinal damage and ensure that your body is effectively absorbing the vitamins and minerals that you—and your baby—need. A diagnosis of celiac disease can be scary, but for women who have suffered miscarriage, understanding how the condition may have impacted their pregnancy is important.
Fortunately, celiac disease can be effectively managed with a gluten-free diet. This is also true for women with celiac who are expecting; staying gluten-free is an important part of a healthy pregnancy. If you have suffered a miscarriage and suspect that gluten sensitivity or celiac disease may be to blame, talk with your healthcare provider.
Following a gluten-free diet can be challenging. We're here to help. Sign up and receive our free recipe guide for delicious gluten-free meals! Celiac Disease Foundation. What is celiac disease? Reproductive life disorders in Italian celiac women. A case-control study. BMC Gastroenterol.
Johns Hopkins Medicine.
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