Celiac disease is not a risk factor for infertility in men

Cancer Epidemiology Unit, Center for Experimental Research and Medical Studies and Center for Oncologic Prevention in Piedmont, University of Turin, Turin, Italy.
Fertility and sterility (Impact Factor: 4.59). 02/2011; 95(5):1709-13.e1-3. DOI: 10.1016/j.fertnstert.2011.01.132
Source: PubMed


To examine fertility in men with biopsy-verified celiac disease (CD) in light of research that suggests that men with CD have impaired sperm quality.
Using multinomial logistic regression and Cox regression, we estimated the fertility of the study group compared with that of 31,677 age-matched reference male controls.
Swedish nationwide population-based cohort of 7,121 men with CD (defined according to duodenal-jejunal biopsy data with [Marsh III] villous atrophy) ages 18-54 years at some point before the end of follow-up.
Number of children according to the Swedish Multi-Generation Register.
During follow-up, men with CD had 9,935 children compared with 42,245 among controls. Adjusting for age, calendar period, and parity and stratifying by education, the overall fertility hazard ratio in the men with biopsy-verified CD was 1.02 (95% confidence interval, 0.99-1.04).
This study found a normal fertility in men with diagnosed CD.

4 Reads
  • [Show abstract] [Hide abstract]
    ABSTRACT: 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. 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%). 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). 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.
    No preview · Article · Sep 2011 · Scandinavian Journal of Gastroenterology
  • [Show abstract] [Hide abstract]
    ABSTRACT: This article critically summarizes the recent scientific and clinical advances in coeliac disease. Epidemiological studies have shown that coeliac disease is as common in parts of Asia, Africa and Eastern Europe as in the western world. Genome-wide association studies continue to identify genetic susceptibilities that are both unique to coeliac disease and overlap with other autoimmune diseases. Human leukocyte antigen genotyping offers additional sensitivity in detecting coeliac disease in individuals who have self-prescribed gluten-free diets (GFD) or have atypical presentations. Immunological advances have highlighted the potential proinflammatory pitfalls of vitamin A supplementation in active coeliac disease and have enabled identification of oat and barley subsets that may be safely incorporated into coeliac diets. Large population-based studies have expanded our knowledge of the long-term risks of coeliac disease, in addition to excluding infertility as a cause for concern once a GFD has been established. The long-term implications of active coeliac disease emphasize the need for early detection and strict adherence to GFD, which remains the cornerstone of management. Technological advances in food modulation and immuno-therapies offer promise, but remain in the translational phases of clinical trials at present.
    No preview · Article · Nov 2011 · Current opinion in gastroenterology
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The aim of this study was to dissect the autoantibody response in celiac disease (CD) that remains largely unknown, with the goal of identifying the disease-specific autoantigenic protein pattern or the so called epitome. Sera from CD patients were used to select immunoreactive antigens from a cDNA phage-display library. Candidate genes were identified, the corresponding proteins produced and their immunoreactivity validated with sera from CD patients and controls. Thirteen CD-specific antigens were identified and further validated by protein microarray. The specificity for 6 of these antigens was confirmed by ELISA. Furthermore we showed that this antibody response was not abolished on a gluten free diet and was not shared with other autoimmune diseases. These antigens appear to be CD specific and independent of gluten induction. The utility of this panel extends beyond its diagnostic value and it may drive the attention to new targets for unbiased screens in autoimmunity research.
    Full-text · Article · Apr 2013 · Clinical Immunology
Show more