צליאק, גלוטן ופוריות

נמצאה באמת שכיחות גבוה יותר של מחלת צליאק לא מאובחנת בקרב נשים עם אי פריון. יש גם טענה שדיאטה דלת גלוטן תשפר את התוצאות של ההריון בנשים עם צליק. לא מקובל עדיין לבדוק באופן שיגרתי לנוכחות סמנים של המחלה אצל נשים ללא תסמינים אך עם בעית פריון. ברור שאם יש חשד למחלה מומלץ גם אצל מטופלות IVF לעשות את הבדיקה מאחר ויתכן וכך יימנעו גם הפלות ובעיות במהלך ההריון. ראי גם: A risk factor for female fertility and pregnancy: celiac disease. Gynecol Endocrinol 2000 Dec;14(6):454-63 Stazi AV, Mantovani A. Laboratory of Comparative Toxicology and Ecotoxicology, Istituto Superiore di Sanita, Rome, Italy. Celiac disease is a genetically-based intolerance to gluten. In the past, celiac disease has been considered a rare disease of infancy characterized by chronic diarrhea and delayed growth. Besides the overt enteropathy, there are many other forms which appear later in life; target organs are not limited to the gut, but include liver, thyroid, skin and reproductive tract. It is now recognized that celiac disease is a relatively frequent disorder; the overall prevalence is at least 1:300 in Western Europe. Celiac disease may impair the reproductive life of affected women, eliciting delayed puberty, infertility, amenorrhea and precocious menopause. Clinical and epidemiological studies show that female patients with celiac disease are at higher risk of spontaneous abortions, low birth weight of the newborn and reduced duration of lactation. No adequate studies are available on the rate of birth defects in the progeny of affected women; however, celiac disease induces malabsorption and deficiency of factors essential for organogenesis, e.g. iron, folic acid and vitamin K. The overall evidence suggests that celiac disease patients can be a group particularly susceptible to reproductive toxicants; however, the pathogenesis of celiac disease-related reproductive disorders still awaits clarification. At present, like the other pathologies associated with celiac disease, the possible prevention or treatment of reproductive effects can only be achieved through a life-long maintenance of a gluten-free diet. Hum Reprod 1999 Nov;14(11):2759-61 Related Articles, Links The prevalence of coeliac disease in infertility. Meloni GF, Dessole S, Vargiu N, Tomasi PA, Musumeci S. Clinica Pediatrica 'A. Filia', Universita di Sassari, 07100 Sassari, Clinica Ostetrica e Ginecologica, Universita di Sassari, Sassari, and Ospedale 'S. Giovanni di Dio', 07026 Olbia, Italy. An increased incidence of reproductive problems, including infertility, miscarriage, low birth weight newborns, and shorter duration of breast-feeding, are known to exist in women with coeliac disease; some of these conditions are improved by a gluten-free diet. We have tried to ascertain the prevalence of coeliac disease in 99 couples who were being evaluated for infertility, compared with the known prevalence of silent disease in the population of Northern Sardinia, in which it is endemic. Of all women, four tested positive for at least two out of three markers: immunoglobulin A (IgA) antigliadin, immunoglobulin (IgG) antigliadin, and anti-endomysium antibodies, and underwent a jejunal biopsy; three had histological evidence of coeliac disease. One male partner was positive for two markers, and had a diagnostic jejunal biopsy. The prevalence of coeliac disease in infertile women seems higher (three out of 99, 3. 03%) in the study group than in the general population (17 out of 1607, 1.06%), and particularly in the subgroup with unexplained infertility (two out of 25, 8%, P < 0.03). Screening for coeliac disease should be part of the diagnostic work-up of infertile women, particularly when no apparent cause can be ascertained after standard evaluation.