The Link Between Celiac And Infertility

[adm07]

Hi!

So I'm still not sure if I am gluten intolerant but I was wondering what caused Celiac patients to suffer from infertility. Is it the vitamin malabsorption that lowers progesterone levels? Do any of you have any good articles on this topic? All I have read is that Celiac is associated with infertility but it doesn't explain HOW. For example, I have amenorrhea, and my SHBG level is extremely low. I read that this could be due to excess insulin. When I tried to see if Celiac had anything to do with it I couldn't find anything.

Any ideas?

thanks!

[tarnalberry]

As far as I understand it, at least part of the reason is simply because the body is not getting enough nutrients. If there isn't a reasonably good environment for the body to sustain a pregnancy, it won't. (I haven't seen any actual studies that investigate, if a woman is ovulating, that she has a lower chance of *conceiving* if an untreated celiac. As the majority of conceptions are lost before they are known about (in the first two weeks or so, before a pregnancy test would show positive), it's probably pretty hard to tell. (Other forms of malnutrition can cause infertility as well, merely because there is inadequate supplies for fetal growth.)

Of course, if malabsorption is keeping you from having a period, and hence, from ovulating (which is common, partially because of low body fat levels, body fat being a producer of estrogen for women), it'd would be impossible to get pregnant, of course.

And, I don't think we can discount the stress on the body of untreated celiac. You've got an immune system running amok, and that puts a lot of chemical stress on the body. That makes for a bad environment that the body may decide is inappropriate for growing a child. (Just like any significant other type of stress.) I don't think you'll be able to narrow down a single biochemical pathway to explain that - it is probably multifactorial and inextricably interconnected.

Pregnancy is extraordinarily chemically complex, and there is a whole lot about it that is still quite a mystery.

[adm07]

thank you so much for your input! I really appreciate it.

I'm trying to look at all points of view as to why I have always been so irregular. I got my first period at a normal time (I was 12) and I always grew at an adequate pace. I was just diagnosed with Hashimoto's thyroiditis and I knew I had PCOS but I was wondering if gluten was maybe a factor to my missing period. I'm waiting for my results from Entero lab but since I don't have any malabsorption issues (no calcium deficiencies or anemia), I'm thinking that may not be the culprit.

You're right, the hormones and everything is just so complicated! I'm working really hard on balancing them.

[Karrin]

I've read a lot on it as well. There have been a few times inflamation was mentioned. My periods have always been clockwork - different than your situation. My husband and I had been trying for roughly 5 years to conceive and less than 2 weeks gluten free I discovered I was pregnant. I did end up miscarrying shortly afterward. But I do tend to agree with the hypothesis that for whatever reason I was probably conceiving prior to starting the diet but losing them before it ever progressed enough to be noticed. I just stumbled upon an interesting bit of info the other day while researching side effects of prednisone (my doctor just started me on it - we have been suspecting other immune related disorders like RA and lupus).

I plan on bringing it up to my doctor on my next appointment.

Open Original Shared Link

Aspirin/Heparin/Prednisone

The use of heparin, baby aspirin, and prednisone may be suggested to help you achieve or maintain a pregnancy. Although there is little published evidence on the benefit of these medications (except in cases of recurrent spontaneous miscarriage and pregnancy complicated by preeclampsia), the premise is that the unexplained infertile woman may actually be able to achieve fertilization and embryo development but the embryo fails to implant. In that sense, they are having very early miscarriages. There are many theories on why this occurs: lack of blocking antibodies, the presence of autoimmune disorders that activate the immune system to over-respond and injure the pregnancy, the prevalence of silent hyperclotting states. We believe that patients with endometriosis, salpingitis isthmica nodosa, Hashimoto's thyroiditis, Raynaud's disease, lupus, rheumatoid arthritis, and other autoimmune disorders may initiate a response that makes a woman's blood more likely to over-clot.

In infertile patients, blood flow in the ovary and uterine lining/endometrium is predictive of outcome. In other words, the ability of the endometrial to develop adequately to support a pregnancy determines whether or not the pregnancy will be successful. The use of low dose aspirin pre-conceptually (cycle day three and on) has improved pregnancy outcomes. Dr. Alan Beer, Chicago, has published improved pregnancy rates among women who suffer recurrent miscarriages using heparin, also starting on cycle day three.

Infertility is associated with higher perinatal morbidity and mortality: three fold risk of stillbirth, five fold risk of preeclampsia, four fold risk of miscarriage, two fold risk of pre-term labor, and increased risk of intrauterine growth retardation. Current literature is beginning to pose associations of these complications with increased clotting and fibrin formation. Since 1993 we have suggested that the invariance among all these things may be fibrin deposition with vessel spasm and abnormalities in implantation and development of the placenta. This means there may be a hidden clotting disorder (s) that is unmasked during pregnancy and interferes with the maternal-fetal interchange. Excessive fibrin deposition is the most common finding of the placenta in these situations. If soluble fibrin monomer (SFM) in a non-pregnant state is greater than 40, the risk of stillbirth is 5%. In our experience of 8 patients who had SFM greater than 100, 6 achieved pregnancy and 4 of the 6 delivered babies between 30 and 34 weeks.

Recent literature shows a direct connection with polycystic ovarian syndrome, insulin resistance, and increased net clotting. The defect, a deficient anti-clotting mechanism, makes normal clotting a problem. The end result is an elevated fibrin deposition. (A scab is made of fibrin.) It is our belief that elevated fibrin is also associated with many abnormal reproductive states.

Over the past few years, there has been much interest focused on the role of nitric oxide (NO) as an enhancer of uterine blood flow as well as a mediator of blood vessel smooth muscle dilation in other areas of the body. Heparin increases nitric oxide that in turn leads to improved blood flow throughout the body: Hands are warmer and less blotchy and most of the thin endometrial linings we see improve. Because we have seen a significant number of women with defined clotting problems, heparin appears to address the clotting issues as well as the vessel spasm issues and improve pregnancy outcomes. Other medications that may produce increased nitric oxide formation include Viagra and calcium channel blockers (used to treat high blood pressure).

Heparin, a naturally occurring substance produced from our blood vessels, helps maintain the blood flowing as a liquid. Given by injection (subcutaneous or intravenous), it is a large molecule that does not pass through the placenta. Excessive amounts of heparin, however, will prevent blood from clotting that can lead to bleeding. For this reason, heparin doses are monitored through blood tests (prothrombin time, or, PTT) drawn four to six hours after the morning dose and carefully titrated to keep your PTT slightly above normal. Short-term use of heparin is considered safe. Long-term heparin use, however, is associated with increased bone loss. Pregnancy is a bone-losing situation and heparin adds to that loss. As a result, the risk of a bone fracture is thought to be as high as 15%. The fracture could be as slight as a stress fracture in the hand or foot or as significant as a vertebral crush fracture as seen in elderly postmenopausal women. Unfortunately, taking calcium does not appear to reverse that effect. Another risk associated with long-term heparin use is a drop in circulating platelets. Platelets help initiate the blood clotting mechanism that blocks small holes in the vessel walls. If platelet counts drop, heparin will have to be discontinued and another medication considered. A drop in platelets, called thrombocytopenia, occurs in 1-3% of the patients on long-term heparin therapy and most often resolves spontaneously once the heparin has been discontinued. Heparin can also cause bruises and wheals to form at the site of the injection and an infection can develop if the injections are not done using aseptic technique.

A daily baby aspirin has been shown to be effective in several disease states during pregnancy including preeclampsia and recurrent miscarriage associated with antiphospholipid antibodies. Aspirin, in conjunction with heparin, is used to treat women who have

[KRP78]

I was overjoyed when I discovered this site, and particularly this infertility-related discussion thread, last night. My husband and I have been trying to conceive for five years, and tests have ruled out all possible problems with our reproductive systems. I have long suspected that the issue was auto-immune for me -- I have chronic ideopathic (i.e., un-diagnosable) hives, which are likely just my immune system attacking my body, and I wouldn't be the least bit surprised if my body were attacking a zygote/embryo in the same way. My mom has always thought I had a gluten intolerance based on my sluggishness after eating wheat products and my stomach irritation (and moms are always right). So I finally decided to make a change.

I am officially two days gluten-free, and feel amazing! I will be printing out the article above and taking it to my next Ob/Gyn appt -- hopefully this will be the issue that we can finally resolve, just by changing my diet.

Thanks to all of you for giving me hope!