Risk of infertility in patients with celiac disease: a meta-analysis of observational studies

Arq Gastroenterol. Apr-Jun 2014;51(2):144-50. doi: 10.1590/s0004-28032014000200014.


Context: Celiac disease is an autoimmune disorder of the small intestine associated with several extra-intestinal features, such as reproductive disorders. The relationship between celiac disease and infertility has been previously assessed, with conflicting results.

Objectives: We seek to determine the relationship between celiac disease and infertility.

Methods: Data was extracted from case-control or cohort design studies from 1966 to December 2013 using the MEDLINE-Pubmed, EMBASE, LILACS and Cochrane Library databases. We analyzed two kinds of trials: those assessing the risk of infertility in subjects with already diagnosed celiac disease, and those evaluating the prevalence of undiagnosed celiac disease in subjects with a diagnosis of infertility.

Results: The search yielded 413 potentially relevant studies for revision, 12 of which were finally included for analysis. A significant association was found between women with a diagnosis of infertility and undiagnosed celiac disease [OR 3.09 (95% CI 1.74-5.49)]. When considering those studies assessing the occurrence of infertility in subjects with already-diagnosed celiac disease, no difference was found between celiac disease patients and control subjects [OR 0.99 (0.86-1.13)].

Conclusions: Undiagnosed celiac disease is a risk factor for infertility. Women seeking medical advice for this particular condition should be screened for celiac disease. Adoption of a gluten-free diet could have a positive impact on fertility in this group of patients.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Celiac Disease / complications*
  • Female
  • Humans
  • Infertility, Female / etiology*
  • Observational Studies as Topic
  • Prevalence
  • Risk Factors