Gunn Beth, Murphy Kellie E, Greenblatt Ellen M
Mount Sinai Fertility, Department of Obstetrics & Gynaecology, Mount Sinai Hospital, Toronto, ON.
Mount Sinai Fertility, Department of Obstetrics & Gynaecology, Mount Sinai Hospital, Toronto, ON; Department of Obstetrics & Gynaecology, University of Toronto, Toronto, ON.
J Obstet Gynaecol Can. 2018 Mar;40(3):293-298. doi: 10.1016/j.jogc.2017.07.008. Epub 2017 Nov 10.
The aims of this study were to examine the prevalence of Celiac disease (CD) in Canadian women with unexplained infertility versus women with an identifiable cause of infertility and to assess the sensitivity of the point-of-care Biocard Celiac Test Kit versus standard serum serologic testing.
In this prospective cohort study, women aged 18 to 44 who were evaluated for infertility between February 2010 and May 2012 at a tertiary academic care fertility clinic in Toronto, ON, were invited to participate. They were categorized as having unexplained infertility (Cases) or infertility secondary to a known cause (Controls). Women on a gluten-free diet or previously diagnosed with CD were excluded. Outcome measures were the Celiac Questionnaire, serum testing for tissue transglutaminase IgA antibody (anti-tTG IgA), serum IgA levels, and Biocard Celiac Test Kit.
Of 685 women approached, 1.2% (4/326) with unexplained infertility and 1.1% (4/359) with an identifiable infertility cause were newly found to have CD. Biocard testing revealed the same results as standard serologic IgA and anti-tTG IgA testing.
CD was not more common in women with unexplained infertility than those with an identifiable cause of infertility. These results do not support the routine screening of Canadian women with infertility for CD.
本研究旨在调查加拿大不明原因不孕症女性与有明确不孕原因女性中乳糜泻（CD）的患病率，并评估即时检测生物卡乳糜泻检测试剂盒相对于标准血清学检测的敏感性。
在这项前瞻性队列研究中，邀请了2010年2月至2012年5月期间在安大略省多伦多市一家三级学术医疗生育诊所接受不孕症评估的18至44岁女性参与。她们被分为不明原因不孕症患者（病例组）或继发于已知原因的不孕症患者（对照组）。排除采用无麸质饮食或先前被诊断为乳糜泻的女性。观察指标包括乳糜泻问卷、组织转谷氨酰胺酶IgA抗体（抗tTG IgA）血清检测、血清IgA水平以及生物卡乳糜泻检测试剂盒。
在685名受邀女性中，新发现患有乳糜泻的不明原因不孕症患者占1.2%（4/326），有明确不孕原因的患者占1.1%（4/359）。生物卡检测结果与标准血清学IgA和抗tTG IgA检测结果相同。
不明原因不孕症女性中乳糜泻的发病率并不高于有明确不孕原因的女性。这些结果不支持对加拿大不孕症女性进行乳糜泻的常规筛查。
