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Hum. Reprod. Advance Access first published online on September 19, 2005
This version published online on October 5, 2005
Human Reproduction, doi:10.1093/humrep/dei314
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© The Author 2005. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oupjournals.org
Received July 22, 2005
Revised August 22, 2005
Accepted August 23, 2005

Article

Serological testing for celiac disease in women undergoing assisted reproduction techniques

Gian Mario Tiboni 1*, Maria Grazia de Vita 1, Raffaella Faricelli 2, Franca Giampietro 1, and Marco Liberati 1

1 Sezione di Ostetricia e Ginecologia, Dipartimento di Medicina e Scienze dell’Invecchiamento, Facoltà di Medicina e Chirurgia, Università "G. d’Annunzio" Chieti-Pescara
2 Servizio Laboratorio Analisi, Ospedale "SS Annunziata", 66013-Chieti, Italy

* To whom correspondence should be addressed.
Gian Mario Tiboni, E-mail: tiboni{at}unich.it


  Abstract

BACKGROUND: The assertion of a causal relationship between celiac disease and infertility is suggested by several lines of research. Nevertheless, robust evidence has not yet been provided. The present study evaluated, for the first time, the prevalence of celiac disease in women undergoing assisted reproduction techniques (ART). METHODS: Serum samples from 200 Italian women undergoing ART were evaluated for celiac disease by endomisium antibody (EMA) and transglutaminase antibody (t-TGA)--two highly sensitive and specific serological markers. Two hundred women not reporting reproductive problems and having delivered at least one child served as controls. In cases of positive serology, the diagnosis was confirmed by jejunal biopsy. RESULTS: Five (2.5%) women from the study group and two (1.0%) from the control group were found to have celiac disease (P = 0.44). The main indications for ART in women found to have celiac disease were tubal factor in two cases and male infertility in three cases. None of these women reported major gastrointestinal complaints. Extra intestinal signs linked to celiac disease were noted in four out of five patients. CONCLUSION: This study raises the issue of celiac disease screening in ART programmes. Given the available evidence in the literature combined with our observations from this study, the value of serological testing for celiac disease in infertile women remains uncertain. Further studies to address this issue are required.

Keywords: assisted reproduction techniques/celiac disease/infertility/serologic screening.
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