Serological testing for celiac disease in women undergoing assisted reproduction techniques.
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.


CONCLUSIONS
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.
Tiboni
Gian Mario
GM
Sezione di Ostetricia e Ginecologia, Dipartimento di Medicina e Scienze dell'Invecchiamento, Facoltà di Medicina e Chirurgia, Università G. d'Annunzio Chieti-Pescara and Servizio Laboratorio Analisi, Ospedale SS Annunziata, Chieti, Italy. tiboni@unich.it
de Vita
Maria Grazia
MG
Faricelli
Raffaella
R
Giampietro
Franca
F
Liberati
Marco
M
D000328:Adult; D001323:Autoantibodies / Q000097:blood; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D002446:Celiac Disease / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000150:complications*; D007558:Italy; D007583:Jejunum / Q000473:pathology; D027724:Reproductive Techniques, Assisted; D012307:Risk Factors; D012698:Serologic Tests
D001323:Autoantibodies; D015415:Biomarkers