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Arq Gastroenterol. 2014 Apr-Jun;51(2):144-50.

Risk of infertility in patients with celiac disease: a meta-analysis of observational studies.

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1
Gastroenterology Division, Internal Medicine Department, Centro de Educación Médica e Investigación Clínica - CEMIC, Buenos Aires, Buenos Aires, Argentina.

Abstract

CONTEXT:

Celiac disease is an autoimmune disorder of the small intestine associated with several extra-intestinal features, such as reproductive disorders. The relationship between celiac disease and infertility has been previously assessed, with conflicting results.

OBJECTIVES:

We seek to determine the relationship between celiac disease and infertility.

METHODS:

Data was extracted from case-control or cohort design studies from 1966 to December 2013 using the MEDLINE-Pubmed, EMBASE, LILACS and Cochrane Library databases. We analyzed two kinds of trials: those assessing the risk of infertility in subjects with already diagnosed celiac disease, and those evaluating the prevalence of undiagnosed celiac disease in subjects with a diagnosis of infertility.

RESULTS:

The search yielded 413 potentially relevant studies for revision, 12 of which were finally included for analysis. A significant association was found between women with a diagnosis of infertility and undiagnosed celiac disease [OR 3.09 (95% CI 1.74-5.49)]. When considering those studies assessing the occurrence of infertility in subjects with already-diagnosed celiac disease, no difference was found between celiac disease patients and control subjects [OR 0.99 (0.86-1.13)].

CONCLUSIONS:

Undiagnosed celiac disease is a risk factor for infertility. Women seeking medical advice for this particular condition should be screened for celiac disease. Adoption of a gluten-free diet could have a positive impact on fertility in this group of patients.

PMID:
25003268
[Indexed for MEDLINE]
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