Screening for unrecognized coeliac disease in subfertile couples

Abstract

Objective. Subfertility has been reported as a long-term complication of unrecognized and/or untreated coeliac disease (CD); however, the results from studies on this topic are ambiguous. We aimed to determine the prevalence of unrecognized CD in subfertile male–female couples visiting a fertility clinic compared with the general population. Methods. Subjects included 1038 male–female couples (n = 2076) who visited the fertility clinic of the Leiden University Medical Center in the Netherlands between 2003 and 2009. All consecutive patients were routinely, serologically screened, and those with positive test results for antibodies against IgA anti-tissue transglutaminase type 2 and IgA endomysial antibodies were considered to have unrecognized CD. Clinical data on gender, age, height, weight, diagnosis of subfertility, and previously diagnosed CD were collected from the clinical files. Subsequently, after serological screening, all patients were anonymized. The prevalence of unrecognized CD was compared with the one in the general adult population in the Netherlands (0.35%). Results. The prevalence of unrecognized CD in subfertile male–female couples was 0.48% (10/2076; 6 females and 4 males) and was not significantly more frequent compared with the general population. Compared with the control group, similar CD prevalences were found within the different subfertility categories separately: unexplained subfertility, anovulation, tubal pathology, and male factor (p = NS). Conclusion. In our large study cohort of subfertile male–female couples, the prevalence of unrecognized CD is comparable to the general population in the Netherlands. No association was observed between CD and subfertility in the different subfertility categories and genders.

Key Words::

• celiac disease/epidemiology
• cohort studies
• infertility female
• infertility male

Acknowledgements

We thank Dr ACTM Vossen of the Department of Microbiology of the LUMC for making available the stored serum samples. Funding: This study was financially supported by the Dutch Celiac Disease Consortium (www.celiac-disease-consortium.nl) and the Gratama-LUF research foundation (www.luf.nl). ELIA^™ Celikey^® assays were supported partly in kind by Phadia GmbH, Freiburg, Germany.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.