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02-11-2010 | Gastroenterology | Article

Women with celiac disease have low fertility before, but not after diagnosis

Abstract

Free abstract

MedWire News: Findings from a Swedish population study show that although celiac disease (CD) is not generally associated with reduced fertility, women with the condition do have significantly reduced fertility in the 2 years preceding CD diagnosis.

Women with CD are known to be at increased risk for an adverse pregnancy outcome, and are thought to have a shorter fertile timespan due to later menarche and earlier menopause than women without the condition, say the researchers.

However, studies investigating the association between CD and infertility have produced conflicting results.

To investigate further, Jonas Ludvigsson (Karolinska Institute, Stockholm) and colleagues carried out a nationwide population-based study of 11,495 women with CD aged 18-45 years. A reference cohort of 51,109 age-matched women without CD were recruited for comparison purposes.

The women were followed-up for live births from 18 years of age until the age of 44 years, emigration, death, or the beginning of January 2008.

During the follow-up period, 16,309 and 69,245 births occurred in women with CD and controls, respectively.

Overall, the team found that there was no significant difference in fertility between women with CD and controls. In fact, if anything, women with CD had slightly more children than women in the reference cohort.

However, when date of CD diagnosis was taken into account, fertility was a significant 37% lower in the 2 years preceding diagnosis in CD women than controls. In the 5 years after CD diagnosis, fertility did not differ between women with CD and controls, and following that, fertility was a significant 12% higher in CD women than controls.

Ludvigsson et al conclude: "Women with CD should be informed that active CD may decrease fertility, but that treatment with a gluten-free diet is likely to normalize fertility."

The results of this study are published in the journal Gut.

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By Helen Albert