Can Celiac Disease Cause Infertility?

Can celiac disease cause infertility? Having a gluten-free diet is usually enough to avoid fertility problems. However, this isn't always enough to reverse the effects of the disease. Find out more in this article!
Can Celiac Disease Cause Infertility?
Diego Pereira

Written and verified by the doctor Diego Pereira.

Last update: 11 June, 2022

Celiac disease is a common disorder in the general population and, without a proper diet, often leads to multiple complications in various organs. And what many are unaware of is the fact that celiac disease can cause infertility.

This is due to multiple factors, especially the effects of intestinal malabsorption, placental insufficiency, and hormonal disturbances. Although it usually occurs in women, men can also suffer from it.

If you’d like to know a little more about the subject, below you’ll find useful information explaining the main reasons why these two conditions usually occur together. Read on!

When does celiac disease cause infertility?

Celiac disease only causes infertility when individuals with this disease consume gluten on a long-term basis. This can happen for several reasons, such as the following:

  • A desire not to follow or an inability to respect nutritional recommendations
  • Ignorance of the diagnosis because the symptoms are mild and sporadic

For this reason, it’s unlikely for a woman who has adequate control of the disease -for a prolonged period of time- to suffer infertility. If, despite strict control, the patient has this condition, the doctor may suggest assisted reproduction techniques, as we’ll discuss below.

A woman bent over in pain because she ate gluten.
Uncontrolled celiac disease can lead to infertility.

Find out more: Is it Possible to Get Pregnant Naturally at 45?

Why does celiac disease occur?

This is an autoimmune disorder that involves inflammatory reactions at the level of the digestive tract that occurs as a result of exposure to gluten. This substance exists in large quantities in foods such as flour and wheat.

Due to the large commercial exploitation of these products, it can be difficult – from a social and economic point of view – for patients to maintain a gluten-free diet. The symptoms that may occur are the following:

  • Diarrhea
  • Abdominal distention
  • Weight loss
  • Varied gastrointestinal manifestations

There’s scientific evidence that’s linked celiac disease with infertility -especially in women- on multiple occasions. We’ll mention the alterations in the organism that explain this phenomenon below.

Inflammatory reactions not only cause local effects in the digestive tract but are capable of altering several systems. Thus, celiac disease can cause infertility.

Intestinal malabsorption

One of the most direct consequences of gluten exposure in these patients is damage to the mucosa of the intestine. This can greatly compromise the ability of this organ to absorb micro and macronutrients. The signs and symptoms caused by this problem are known as intestinal malabsorption syndrome.

Unfortunately, some essential micronutrients for the body – such as iron and vitamin B12 – are indispensable for the embryo to implant in the walls of the endometrium and begin to develop little by little. This partly explains the origin of infertility.

Placental insufficiency

The placenta is a very important organ that allows the passage of nutrients from the mother to the embryo or fetus. As the immune system covers all organs, sometimes the antibodies produced against gluten can damage this tissue and cause placental insufficiency.

This means that the placenta doesn’t fulfill its functions as it should. The most direct consequence is that the embryo can0t develop properly, resulting in miscarriage. Such an event can occur on multiple occasions, and it’s difficult to make a diagnosis when the mother has no other obvious symptoms of celiac disease.

Hormonal problems

This aspect helps to explain male infertility. The same lack of micronutrients can cause significant hormonal imbalances, especially when they affect testosterone. Testosterone is the male sex hormone and plays an important role in spermatogenesis.

This process is intended to form spermatozoa, which are the male sex cells that carry out fertilization together with the female eggs. Chronic testosterone depletion can negatively influence spermatogenesis.

A doctor talking to a male patient about infertility.
In men, celiac disease can have an impact on hormonal problems such as decreased testosterone.

Find out more: The 6 Most Common Causes of Infertility in Women

What are the treatment options?

Control of the underlying disease is essential to avoid infertility, whether due to problems with embryo implantation or repeated miscarriages. This control consists of a strict gluten-free diet. Fortunately, many of these products can nowadays be found in supermarkets.

While this should be sufficient, infertility isn’t always reversible or preventable. A valid option for these patients is assisted reproduction in any of its modalities. The most well-known are the following:

In some countries, these are part of the public health system, although, in many places, they can only be accessed through private clinics.

Can celiac disease cause infertility? An appropriate diet is often the solution

A patient with celiac disease can live normally as long as they follow the nutritional recommendations given to them. This goes beyond digestive discomfort, as prolonged exposure to gluten can also cause disorders of the nervous system, cardiovascular system, and, of course, infertility.

All cited sources were thoroughly reviewed by our team to ensure their quality, reliability, currency, and validity. The bibliography of this article was considered reliable and of academic or scientific accuracy.

  • Ivarsson A. The Swedish epidemic of coeliac disease explored using an epidemiological approach –some lessons to be learnt. Best Pract Res Clin Gastroenterol 2005;19:425-40.
  • Martos I, et al. Influencia de la enfermedad celíaca en los trastornos de la fertilidad y del embarazo. Paraninfo Digital 2018;XII(28):e105.
  • Polanco I, et al. Enfermedad celíaca. Protocolos diagnóstico-terapéuticos de Gastroenterología, Hepatología y Nutrición Pediátrica SEGHNP-AEP.
  • Sheiner E, Peleg R, Levy A. Pregnancy outcome of patients with known celiac disease. Eur J Obstet Gynecol Reprod Biol. 2007;129(1):41-45.
  • Zugna D, Richiardi L, Akre O, Stephansson O, Ludvigsson JF. A nationwide population based study to determine whether coeliac disease is associated with infertility. Gut. 2010:59(11):1471-1475.

This text is provided for informational purposes only and does not replace consultation with a professional. If in doubt, consult your specialist.