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There are many dire diseases associated with celiac disease however none are so insidious as its effect on fertility. While other diseases manifest themselves with observable symptoms, infertility is the absence of something (pregnancy) that until recently could not be proved or even inferred. While the information quoted below is not definitive, it strongly suggests that untreated CD can increase infertility and that maintaining a strict gluten free diet can massively reduce infertility effects.
The effects on pregnancy are better defined and are discussed at the end of this article.
CD FEMALE FERTILITY
The papers on celiac disease and infertility seem to quote the same statistics, which since 2000 all retain the same positive message. That is, If you are celiac, you must maintain your gluten free diet while attempting pregnancy and once successful, during pregnancy. The only extra advice is to replace the vitamins and minerals that you may be missing by excluding gluten grains from your diet.
The reason for maintaining a gluten free diet during attempts at conception are that it is believed that Infertility and miscarriage in celiacs are caused by mal-absorption affects - due to the body's inability to absorb the nutrients required conceive and then carry a healthy baby. In fact studies have shown that "the incidence of celiac disease in women with unexplained infertility has been estimated at four to eight percent" (ref 1)
Researchers also found that "CD women who were not on the gluten-free diet started their menstrual cycle up to a year and a half later than women with celiac disease who were following the diet. In addition, researchers found that up to 39% of women not on the gluten free diet experienced periods of amenorrhea (irregular periods), compared to only nine percent of CD women who were on the gluten-free diet. Women with celiac disease who were not on the gluten-free diet were found to enter menopause four to five years earlier than women with celiac disease who were on the diet. (ref 1)
"Researchers who have studied women with infertility have found that they test positive for celiac disease-related antibodies at a rate that is ten-fold higher than the normal population." (ref 1). It is noted that many of these ‘infertile' women often go onto delivering healthy babies, assisted by eating a strict gluten free diet.
"Celiac disease and infertility causes the menstrual cycle to be an on again off again thing. Unfortunately, under those conditions, it may take longer to become pregnant, if at all, since a gluten free diet may bring on the menstrual cycle earlier and menopause earlier." (ref 2)
While none of this data proves that celiac disease causes infertility, it strongly suggests that people diagnosed as celiacs are likely to have more difficulty conceiving and they can massively improve their chances when observing a strict gluten free diet.
CD MALE FERTILITY
"A Male CD person has a greater risk of infertility and other reproductive disturbances, as well as a greater incidence of hypoandrogenism." (ref 4) This medical condition means a deficiency of androgens in the body that leads to a lack of virility and sexual potency.
"As regards nutritional aspects, the folic acid deficiency of CD can affect rapidly proliferating tissues, such as the embryo and the seminiferous epithelium. More attention should be paid to deficiencies of fat-soluble vitamins, such as A and E, observed in CD. Vitamin A is important for Sertoli cell function as well as for early spermatogenetic phases. Vitamin E supports the correct differentiation and function of epidydimal epithelium, spermatid maturation and secretion of proteins by the prostate. Therefore, CD male patients should be considered as vulnerable subjects" (ref 4).
The practical conclusion of this is that just as CD has a profound effect on women's fertility, it has a similar effect on male fertility via the quality of their sperm. Again a gluten free diet is the only viable ‘fix' for infertility issues for males who experience unexplained infertility.
PREGNANCY
The adverse effects of CD are equally devastating on pregnancy, though as for conception, celiacs pregnancies can be restored to near normal by following a gluten free diet. Rather than 'gild the lily' I will simply quote the known statistics below:
"In a study of 25 patients and 60 pregnancies of CD women, researchers found that 21% of women who were not on the gluten-free diet experienced pregnancy loss, and 16% of women experienced fetal growth restriction". (ref 5)
"In a large Danish study with 211 infants and 127 mothers with celiac disease, researchers found that the mean birth weight of children born to mothers on a gluten-containing diet was significantly lower than babies born to mothers without celiac disease. Interestingly, this same study determined that women on the gluten-free diet gave birth to children weighing more than those born to mothers without celiac disease!" In a case-control study that looked at the effect of the gluten-free diet on pregnancy and lactation, investigators learned that women with celiac disease who were not on the gluten-free diet experienced pregnancy loss at a rate of 17.8%, compared to 2.4% of women with celiac disease who were on the gluten-free diet.
"in a group of women with celiac disease who had been pregnant more than once, researchers looked at the effect of the gluten-free diet on their future pregnancies. They concluded that the institution of the gluten-free diet upon diagnosis caused a relative 35.6% drop in pregnancy loss, 29.4% drop in low-birth weight babies and an increase of two and a half months of breastfeeding." (ref 5)
As you can readily see, celiac disease, caused by eating grains that include gluten, has far reaching effects regarding inhibiting reproduction. If you have any of the symptoms (discussed on the site in the ref box), it is a relatively simple process to get yourself checked out. Unexplained infertility is a growing subset of the reason people can not have children. If you think you have some of the symptoms, as well as infertility, there are several non invasive tests you can try before going the IVF path.
REFERENCES
1 http://www.maleinfertilitysolutions.com/celiac-disease-and-infertility.php
2 http://celiac-disease.com/how-does-celiac-disease-cause-infertility/
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