title: Women with celiac disease present with fertility problems no more often than women in the general population.
abstract: OBJECTIVE
  Studies have associated infertility with celiac disease. However, these included small numbers of women attending infertility specialist services and subsequently screened for celiac disease, and therefore may not have been representative of the general population. We performed a large population-based study of infertility and celiac disease in women from the United Kingdom.
  
  
  METHODS
  We identified 2,426,225 women with prospective UK primary care records between 1990 and 2013 during their child-bearing years from The Health Improvement Network database. We estimated age-specific rates of new clinically recorded fertility problems among women with and without diagnosed celiac disease. Rates were stratified by whether celiac disease was diagnosed before the fertility problem or afterward and compared with rates in women without celiac disease using Poisson regression, adjusting for sociodemographics, comorbidities, and calendar time.
  
  
  RESULTS
  Age-specific rates of new clinically recorded fertility problems in 6506 women with celiac disease were similar to the rates in women without celiac disease (incidence rate ratio, 1.12; 95% confidence interval, 0.88-1.42 among women age 25-29 years). Rates of infertility among women without celiac disease were similar to those of women with celiac disease before and after diagnosis. However, rates were 41% higher among women diagnosed with celiac disease when they were 25-29 years old, compared with women in the same age group without celiac disease (incidence rate ratio, 1.41; 95% confidence interval, 1.03-1.92).
  
  
  CONCLUSIONS
  Women with celiac disease do not have a greater likelihood of clinically recorded fertility problems than women without celiac disease, either before or after diagnosis, except for higher reports of fertility problems between 25-39 years if diagnosed with CD. These findings should assure most women with celiac disease that they do not have an increased risk for fertility problems.
authors.affiliation: Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, City Hospital, Nottingham, United Kingdom. Electronic address: nafeesa.dhalwani@nottingham.ac.uk.
authors.forename: Nafeesa N
authors.initials: NN
authors.lastname: Dhalwani
authors.affiliation: Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, City Hospital, Nottingham, United Kingdom.
authors.forename: Joe
authors.initials: J
authors.lastname: West
authors.affiliation: Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, City Hospital, Nottingham, United Kingdom.
authors.forename: Alyshah Abdul
authors.initials: AA
authors.lastname: Sultan
authors.affiliation: Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, City Hospital, Nottingham, United Kingdom.
authors.forename: Lu
authors.initials: L
authors.lastname: Ban
authors.affiliation: Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, City Hospital, Nottingham, United Kingdom.
authors.forename: Laila J
authors.initials: LJ
authors.lastname: Tata
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D002446:Celiac Disease / Q000453:epidemiology*; D015897:Comorbidity; D004502:Education, Medical, Continuing; D005260:Female; D006801:Humans; D015994:Incidence; D007247:Infertility, Female / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors; D006113:United Kingdom / Q000453:epidemiology; D055815:Young Adult
keywords: Food Allergy; Gluten; Pregnancy; Risk Factor