No link between celiac disease, male infertility

NEW YORK Fri Mar 4, 2011 6:21pm EST

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NEW YORK (Reuters Health) - Men with celiac disease are no more likely to suffer from infertility than men without the condition, which makes people intolerant to gluten, suggests a new study from Sweden.

Researchers say the finding is reassuring in light of previous research on the reproductive health of men and women with celiac disease.

"Several earlier studies have shown lower fertility in women with celiac disease, and one could then suspect that infertility would occur also in men with celiac disease," Dr. Jonas Ludvigsson, one of the study's authors from rebro University Hospital in Sweden, told Reuters Health in an email.

What's more, he said, men with celiac disease may have hormone disturbances and problems with their sperm quality.

About one percent of Americans have celiac disease. The condition means their immune system reacts to gluten -- a protein found in wheat, barley, and rye -- causing damage to the small intestine and keeping it from absorbing nutrients.

Preventing long-term health consequences requires sticking to a strict gluten-free diet.

In the current study, published in the journal Fertility and Sterility, researchers tracked about 7,000 Swedish men who had been diagnosed with celiac disease and 32,000 similarly aged men without celiac disease.

Using a national database, the researchers were able to determine how many children each man had and when those children were born in relation to his celiac diagnosis. Men included in the study were born between 1914 and 1990, and the researchers followed them until they turned 54, or until the study ended in 2008, whichever came first.

By 2008, men with celiac disease had fathered close to 10,000 children, for an average of 1.4 children each. Men without celiac disease had about 42,000 children, or 1.3 children per man.

In all time periods the researchers looked at, both before and after celiac disease was diagnosed, men who were ultimately diagnosed with the condition did not suffer from infertility any more than men without celiac disease, as measured by their number of children. At the end of the study, about 35 percent of men with and without celiac disease had not had any children.

Because the study only included men who were born in Sweden and who were still living in Sweden as adults, the authors say that the findings may not necessarily generalize to other men -- but that the large number of men included in the study makes the results more convincing.

While celiac disease may not affect the fertility of men, there is more research to suggest that women with celiac disease are more likely to suffer from infertility than women without celiac disease.

It's not known, however, whether that difference is entirely because of changes in the body as a result of celiac disease, or if women with celiac disease are more likely to put off trying to have a baby because of concerns about health and nutrition, according to the authors.

Dr. Eyal Sheiner, who studies celiac disease at Ben Gurion University of the Negev in Israel, said that when women with celiac disease are untreated, they start menstruating later and hit menopause earlier than other women.

"In addition," he told Reuters Health in an email, "several studies have found that celiac women who do achieve fertilization, often have higher chances of miscarriages" and poor growth of the fetus.

The current study has certain limitations, Sheiner said, including that the authors had to look back on information about men with celiac disease, rather than starting with a group of men with the disease and tracking how many children they had going forward -- which is a more accurate, though more challenging way, of collecting data.

Still, the results are a positive sign for men with celiac disease hoping to have children.

"I am happy I now have good news that (men) with celiac disease do not seem to be at increased risk of infertility," Ludvigsson said.

SOURCE: bit.ly/hvb4aB Fertility and Sterility, online February 21, 2011.

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