Undiagnosed celiac disease in women with infertility

To determine the prevalence of celiac disease in a group of Brazilian women with infertility.

This was a cross-sectional study of 170 infertile Brazilian women tested for immunoglobulin A anti-tissue transglutaminase (IgA anti-tTG), endomysial antibody and total IgA. Women with positive serologies were recommended for intestinal biopsy. Patients with positive serology and villous atrophy on biopsy had the diagnosis of celiac disease, while those with positive serology but no villous atrophy were identified as having latent celiac disease. All of these women were typed for HLA-DQ2 and HLA-DQ8.

The prevalence of celiac disease confirmed by biopsy in the study group was 1.2% (2 out of 170) (95% confidence interval [CI], 0.1-4.2). Considering also those with latent celiac disease, the prevalence was estimated at 2.9% (5 out of 170) (95% CI, 1.0-6.7) and in the subgroup of unexplained infertility the prevalence was 10.3% (3 out of 29) (95% CI, 2.2-27.4). All seropositive patients were also HLA-DQ2 positive.

Further studies are required to define the role of routine serological screening for celiac disease in infertile women as well as to elucidate the underlying mechanism for infertility in active celiac disease.