Abstract
We aimed to estimate the seroprevalence and the prevalence of coeliac disease (CD) in women with reproductive problems. A systematic review of English published articles until June 2019 was performed in PubMed and Scopus using the terms: (infertility and (coeliac disease OR gluten) OR (miscarriage and (coeliac disease OR gluten) OR (abortion and (coeliac disease OR gluten). All articles showing numerical data of anti-transglutaminase type 2 or anti-endomisium antibodies, or intestinal biopsy information were included. The study group comprised women with overall infertility, unexplained infertility, or recurrent spontaneous abortions. Two authors independently performed data extraction using a predefined data sheet. The initial search yielded 310 articles, and 23 were selected for data extraction. After meta-analysis, the pooled seroprevalence was very similar for overall and unexplained infertility, with a pooled proportion of around 1.3%–1.6%. This implies three times higher odds of having CD in infertility when compared to controls. The pooled prevalence could not be accurately calculated due to the small sample sizes. Further studies with increased sample sizes are necessary before giving specific recommendations for CD screening in women with reproductive problems, but current data seem to support a higher risk of CD in these women.
Highlights
Coeliac disease (CD) is a systemic autoimmune disorder causing enteropathy, which occurs after ingestion of dietary gluten in genetically susceptible individuals
The first connection between infertility and CD was described by Morris et al in 1970 [2], who explained the reversion of infertility after a gluten-free diet (GFD) in three CD women
The wide controversy related to CD and infertility relies on all the published work and we aimed to show the basis of such a controversy
Summary
Coeliac disease (CD) is a systemic autoimmune disorder causing enteropathy, which occurs after ingestion of dietary gluten in genetically susceptible individuals. It shows a worldwide prevalence of approximately 1%, this value can differ depending on age, sex, and geographic location [1]. Associated with gastrointestinal symptoms, the clinical manifestations of CD are very heterogeneous and include non-gastrointestinal symptoms such as infertility. The first connection between infertility and CD was described by Morris et al in 1970 [2], who explained the reversion of infertility after a gluten-free diet (GFD) in three CD women. The interest in gynecologic and obstetric manifestations of CD has been increasing.
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