title: Fertility disorder associated with celiac disease in males and females: fact or fiction?
abstract: OBJECTIVE
  The association between celiac disease and infertility is controversial in the literature. The aim of this study was to determine the prevalence of celiac disease among the couples with unexplained infertility.
  
  
  METHODS
  Serum samples from 100 Iranian couples with unexplained infertility were evaluated for celiac disease by tissue transglutaminase antibody (tTGA). Two hundred couples not reporting reproductive problems and having delivered at least one uncomplicated birth served as controls. Total immunoglobulin A (IgA) was also obtained to investigate IgA deficiency. Those with IgA deficiency were tested with IgG tTG. Those cases with positive tTGA or tTGG (IgA deficients) underwent upper gastrointestinal endoscopy.
  
  
  RESULTS
  Positive results of tTGA were detected in 13 infertile subjects (6.5%, 6 males and 7 females) and 11 controls (2.8%, 4 males and 7 females) (P = 0.027). The odds ratio of celiac disease in unexplained infertile couples was 2.39 (95% CI: 1.15-5.01) compared with fertile couples. IgA deficiency was identified in 14 infertile cases and 11 controls. Only 5/24 tTGA-positive and 4/24 IgA-deficient infertile subjects and controls accepted to undergo duodenal mucosal biopsy. Celiac disease was confirmed by biopsy in three (1.5%) of the unexplained infertile patients.
  
  
  CONCLUSIONS
  The results of this study show that there is a higher seroprevalence of celiac disease in those with infertility in comparison to those with normal fertility.
authors.affiliation: Liver and Gastrointestinal Disease Research Center, Tabriz University of Medical Sciences, Tehran, Iran. mkhoshbaten@yahoo.com
authors.forename: Manouchehr
authors.initials: M
authors.lastname: Khoshbaten
authors.forename: Mohammad
authors.initials: M
authors.lastname: Rostami Nejad
authors.forename: Laya
authors.initials: L
authors.lastname: Farzady
authors.forename: Nasrin
authors.initials: N
authors.lastname: Sharifi
authors.forename: Sayyed Hassan
authors.initials: SH
authors.lastname: Hashemi
authors.forename: Kamran
authors.initials: K
authors.lastname: Rostami
mesh_terms: D000328:Adult; D001323:Autoantibodies / Q000097:blood; D002446:Celiac Disease / Q000150:complications* / Q000453:epidemiology* / Q000276:immunology; D005260:Female; D006801:Humans; D007246:Infertility / Q000453:epidemiology* / Q000209:etiology* / Q000276:immunology; D008297:Male; D008403:Mass Screening; D015995:Prevalence; D016036:Seroepidemiologic Studies; D011503:Transglutaminases / Q000276:immunology
chemical_list: D001323:Autoantibodies; D011503:Transglutaminases