Khoshbaten Manouchehr, Rostami Nejad Mohammad, Farzady Laya, Sharifi Nasrin, Hashemi Sayyed Hassan, Rostami Kamran
Liver and Gastrointestinal Disease Research Center, Tabriz University of Medical Sciences, Tehran, Iran.
J Obstet Gynaecol Res. 2011 Oct;37(10):1308-12. doi: 10.1111/j.1447-0756.2010.01518.x. Epub 2011 May 11.
The association between celiac disease and infertility is controversial in the literature. The aim of this study was to determine the prevalence of celiac disease among the couples with unexplained infertility.
MATERIAL & METHODS: Serum samples from 100 Iranian couples with unexplained infertility were evaluated for celiac disease by tissue transglutaminase antibody (tTGA). Two hundred couples not reporting reproductive problems and having delivered at least one uncomplicated birth served as controls. Total immunoglobulin A (IgA) was also obtained to investigate IgA deficiency. Those with IgA deficiency were tested with IgG tTG. Those cases with positive tTGA or tTGG (IgA deficients) underwent upper gastrointestinal endoscopy.
Positive results of tTGA were detected in 13 infertile subjects (6.5%, 6 males and 7 females) and 11 controls (2.8%, 4 males and 7 females) (P = 0.027). The odds ratio of celiac disease in unexplained infertile couples was 2.39 (95% CI: 1.15-5.01) compared with fertile couples. IgA deficiency was identified in 14 infertile cases and 11 controls. Only 5/24 tTGA-positive and 4/24 IgA-deficient infertile subjects and controls accepted to undergo duodenal mucosal biopsy. Celiac disease was confirmed by biopsy in three (1.5%) of the unexplained infertile patients.
The results of this study show that there is a higher seroprevalence of celiac disease in those with infertility in comparison to those with normal fertility.
乳糜泻与不孕症之间的关联在文献中存在争议。本研究的目的是确定不明原因不孕症夫妇中乳糜泻的患病率。
采用组织转谷氨酰胺酶抗体（tTGA）对100对伊朗不明原因不孕症夫妇的血清样本进行乳糜泻评估。200对未报告生殖问题且至少有一次顺产的夫妇作为对照。同时检测总免疫球蛋白A（IgA）以调查IgA缺乏情况。IgA缺乏者用IgG tTG进行检测。tTGA或tTGG（IgA缺乏者）阳性的病例接受上消化道内镜检查。
13例不孕受试者（6.5%，6例男性和7例女性）和11例对照者（2.8%，4例男性和7例女性）tTGA检测结果呈阳性（P = 0.027）。与有生育能力的夫妇相比，不明原因不孕夫妇患乳糜泻的比值比为2.39（95%CI：1.15 - 5.01）。14例不孕病例和11例对照者存在IgA缺乏。仅24例tTGA阳性和24例IgA缺乏的不孕受试者及对照者中的5例和4例接受了十二指肠黏膜活检。3例（1.5%）不明原因不孕患者经活检确诊为乳糜泻。
本研究结果表明，与生育能力正常者相比，不孕症患者中乳糜泻的血清患病率更高。
