title: Screening for unrecognized coeliac disease in subfertile couples.
abstract: OBJECTIVE
  Subfertility has been reported as a long-term complication of unrecognized and/or untreated coeliac disease (CD); however, the results from studies on this topic are ambiguous. We aimed to determine the prevalence of unrecognized CD in subfertile male-female couples visiting a fertility clinic compared with the general population.
  
  
  METHODS
  Subjects included 1038 male-female couples (n = 2076) who visited the fertility clinic of the Leiden University Medical Center in the Netherlands between 2003 and 2009. All consecutive patients were routinely, serologically screened, and those with positive test results for antibodies against IgA anti-tissue transglutaminase type 2 and IgA endomysial antibodies were considered to have unrecognized CD. Clinical data on gender, age, height, weight, diagnosis of subfertility, and previously diagnosed CD were collected from the clinical files. Subsequently, after serological screening, all patients were anonymized. The prevalence of unrecognized CD was compared with the one in the general adult population in the Netherlands (0.35%).
  
  
  RESULTS
  The prevalence of unrecognized CD in subfertile male-female couples was 0.48% (10/2076; 6 females and 4 males) and was not significantly more frequent compared with the general population. Compared with the control group, similar CD prevalences were found within the different subfertility categories separately: unexplained subfertility, anovulation, tubal pathology, and male factor (p = NS).
  
  
  CONCLUSIONS
  In our large study cohort of subfertile male-female couples, the prevalence of unrecognized CD is comparable to the general population in the Netherlands. No association was observed between CD and subfertility in the different subfertility categories and genders.
authors: Department of Paediatric Gastroenterology, Leiden University Medical Center, Leiden, Netherlands. c.e.hogen_esch@lumc.nl
authors: Caroline E
authors: CE
authors: Hogen Esch
authors: Mechteld J L
authors: MJ
authors: Van Rijssen
authors: Anja
authors: A
authors: Roos
authors: Frits
authors: F
authors: Koning
authors: Friedo W
authors: FW
authors: Dekker
authors: M Luisa
authors: ML
authors: Mearin
authors: Frans M
authors: FM
authors: Helmerhorst
authors: Joachim J
authors: JJ
authors: Schweizer
mesh_terms: D000328:Adult; D000858:Anovulation / Q000150:complications / Q000453:epidemiology; D000906:Antibodies / Q000097:blood; D002446:Celiac Disease / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology*; D005184:Fallopian Tube Diseases / Q000150:complications / Q000453:epidemiology; D005260:Female; D019204:GTP-Binding Proteins / Q000276:immunology; D006801:Humans; D007070:Immunoglobulin A / Q000276:immunology; D007246:Infertility / Q000150:complications / Q000453:epidemiology*; D007248:Infertility, Male / Q000150:complications / Q000453:epidemiology; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence; D000091345:Protein Glutamine gamma Glutamyltransferase 2; D012189:Retrospective Studies; D011503:Transglutaminases / Q000276:immunology; D055815:Young Adult
chemical_list: D000906:Antibodies; D007070:Immunoglobulin A; D000091345:Protein Glutamine gamma Glutamyltransferase 2; D011503:Transglutaminases; D019204:GTP-Binding Proteins