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Can ‘unexplained infertility’ be explained?

Approximately 15% to 30% of couples will be diagnosed with unexplained infertility after examining all medical tests performed. It is the most frequent infertility diagnosis given to women. What does this mean? There is nothing wrong or could it be that the physician failed to find the true cause of your infertility?

Could gluten be the culprit?

Researchers were able to detect a significantly increased prevalence of the undiagnosed celiac disease among women presenting with unexplained infertility. Coeliac disease is caused by an inappropriate immune response to dietary gluten. Gluten can be found in wheat, barley, rye and oats. When gluten is consumed, it can cause a wide range of symptoms from fatigue, weight loss or gain, iron deficiency, osteoporosis, itchy rash, headaches to digestive symptoms. Gluten damages the lining of the small intestine and can lead to autoimmune disease, infertility and liver disease.

Should you get tested for Coeliac?

Does this mean you should get tested for Coeliac if you have trouble conceiving? Not necessarily. Generally, a blood test for antibodies is performed, which is then confirmed by a bowel biopsy. The blood test is very limiting as it only tests for some antibodies, and the sensitivity and therefore accuracy of these may depend on the severity of intestinal damage.

It is believed that some degree of gluten reactivity occurs in up to 80% of the population. In other words, you don’t have to be diagnosed with Coeliac for gluten to affect you and therefore your fertility.

What can you do?

Avoid all gluten-containing grains (wheat, barley, rye and oats) for at least 3 months. Take note of any symptoms you may have and your energy levels. If your symptoms and/or energy levels improve, stay off gluten.

What can you eat?

Obviously there are a lot of gluten-free foods available these days, but is it advisable to substitute them for gluten foods? Maybe initially they can serve as a bridge for some gluten-containing foods, but as a general rule, they are highly processed and therefore contain no nutritional value. Instead base your meals around a small portion of protein (meat, fish, chicken, eggs, legumes, nuts) with plenty of vegetables or salad.

References: The Practice Committee of the American Society for Reproductive Medicine, authors. Effectiveness and treatment for unexplained infertility. Fertil Steril. 2006;86(5 suppl):S111–S114 Increased Prevalence of Celiac Disease in Patients with Unexplained Infertility in the United States: A Prospective Study Janet M. Choi, M.D., Benjamin Lebwohl, M.D., M.S., […], and Peter H. R. Green, M.D. Kumar A et al. (December 14, 2010) “Latent celiac disease in reproductive performance of women.” Fertility and Sterility; 16(46):5810-4. Accessed April 12, 2012. D Bernardo, J A Garrote, […], and E Arranz, Is gliadin really safe for non‐coeliac individuals? Production of interleukin 15 in biopsy culture from non‐coeliac individuals challenged with gliadin peptides


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