Celiac disease impacts fertility if left undiagnosed or untreated. The impact of celiac disease on fertility is related to both a gluten-free diet and the damage to the small intestine that occurs with celiac.
In this post, we will dive into fertility, celiac disease, what the research says, and how you can support your fertility with celiac disease.
Written by Devorah Steinberg, revised by Tayler Silfverduk, RDN
Celiac Disease is an immune disease that causes damage to the villi of the small intestines. This can lead to nutrient deficiencies and a wide array of symptoms.
Symptoms of celiac include diarrhea, abdominal pain, and weight loss are just some of the examples of digestive problems that can be triggered when a person with this condition ingests gluten (a protein found in wheat, barley, and rye).
Fertility is the natural ability to conceive a child. Infertility is when conception does not happen after 1 year of unprotected sexual intercourse. Approximately 11% of couples experience infertility, and of those couples 1 in 5 are diagnosed with unexplained infertility (the majority of infertility cases are the result of hormonal problems that stop the ovaries from producing or releasing mature eggs).
When you are unable to conceive a child, this is known as infertility. And unexplained infertility can be a sign of celiac disease.
Key factors that support fertility are age, hormonal health, nutrition, and genetics. However, there are many things that women can do to increase their fertility as well. Studies show that lifestyle factors such as cigarette smoking, or having an irregular sleep cycle can all negatively impact fertility.
Many connections between celiac disease and fertility have been found in research. In fact, fertility is one of many women’s health factors impacted by celiac.
One of the largest studies to be done was a 2014 study from Nottingham University carried out over the course of 23 years, analyzing the data of over 2 million women between the ages of 15 and 45 in the UK. The study showed that women between the ages of 25 and 39 years of age did have an increased risk for fertility issues if they had celiac disease that was untreated or unmanaged.
A 2018 study from Denmark compared the medical records of 6,319 women with celiac disease to the record of 63,166 women without the disease. The study showed that women with undiagnosed celiac disease had 11 more miscarriages per 1000 pregnancies and 1.62 more stillbirths per 1000 pregnancies. Additionally, in the 2 years leading up to a diagnosis of celiac disease, women experienced 25 fewer pregnancies per 1000.
A 2010 study from Sweden of 11,495 women found that fertility was reduced during the two years before the women were diagnosed with celiac disease. Once treated with a gluten free diet, however, normal occurrences of fertility were restored.
This 2014 study came to the same conclusion: Women with untreated and/or undiagnosed celiac disease showed a higher risk of miscarriage, intrauterine growth restriction (fetus not growing as expected), babies born with a low birthweight, and preterm delivery. However the risk for all these conditions are significantly reduced by following a gluten free diet.
The major difference between an undiagnosed or untreated individual with celiac disease and an individual living with managed celiac is the consumption of gluten.
Without the immune response in the small intestine that gluten consumption causes, a person with managed celiac disease will be able to lead a symptom free life. Not only will they physically feel better, but their body should be able to absorb nutrients properly – which is one of the most important factors for fertility.
Undiagnosed or untreated celiac disease results in a damaged duodenum in the small intestines. This in turn, lowers the body’s ability absorb key nutrients – including nutrients needed for reproductive health, such as folic acid, zinc, iron, and B12. A lack of these vitamins have been shown to negatively impact fertility in the following ways:
Based on the studies above, and numerous other (smaller) studies carried out worldwide, celiac Infertility can be reversed by adhering to a completely gluten-free diet and restoring nutrient stores. This reversal is likely due to a gluten-free diet promoting intestinal healing and reduction in inflammation. This will restore the body’s ability to absorb nutrients – a much-needed process for reversing infertility.
So rest assured, as you heal, you should be able to get and maintain a healthy pregnancy with celiac disease.
Though there is more data on Celiac Disease’s effect on women’s infertility readily available, there is some information regarding Celiac’s Disease on male infertility as well. An old study from 1982 found that 19% of married men with Celiac Disease experienced sperm morphology (size and shape) and sperm motility (the ability of sperm to move). However, a later study done in Sweden in 2011 of 7121 men, concluded that men with Celiac Disease do not seem to have impaired fertility, either before or after diagnosis.
During a woman’s childbearing years there are a number of things to do to support fertility. As per this study, nutrition is of key importance, along with being aware of alcohol and caffeine consumption, smoking, stress, and long-term exposure to environmental pollutants.
If you’re fertility experiences are tied to celiac, the best thing you can do is heal your small intestine, heal your relationship with food, and focus on supporting any nutrient gaps you may have related to a damaged small intestine or learning to balance a gluten-free diet.
A reminder: zinc, folic acid, iron, B12, and calcium are all nutrients of concern with celiac and can help support fertility.
Below is a 3-day meal-plan example for what it might look like to incorporate gluten-free foods for fertility. For more support, consider working with a celiac registered dietitian.
You only need to worry about celiac impacting your fertility if you are recently diagnosed, you’re not healing, or you’re inconsistent in staying gluten-free.
That means if you’ve had the proper follow-up testing and have confirmed healing with celiac (both gut and nutrient deficiency wise) then you should not have to worry about your fertility. Unless however, you have another condition that’s playing a role in your fertility health.
Worried about if your eating to support your fertility? Let’s work together to come up with a plan that will leave you feeling good.