Editor—Taylor et al provided an excellent series of clinical reviews on subfertility.1 However, one medical condition that was not mentioned was coeliac disease.
Population screening in the United Kingdom has suggested that coeliac disease has a prevalence of 1%, and this is consistent with other European countries.2 The relation between coeliac disease and subfertility is well described. Subfertility may be the only presenting feature of coeliac disease.
Two recent studies have shown that the prevalence of unrecognised coeliac disease (as a cause of subfertility) in women presenting to subfertility clinics is in the range of 2.7-3%.3,4 Not only this, but failure to recognise coeliac disease is also associated with a poorer outcome for the fetus. There may also be male gonadal dysfunction.5
Given these findings, surely it is time that clinicians list undiagnosed coeliac disease as an important consideration for preconception advice (under the heading of unrecognised or pre-existing medical problems). The relation between coeliac disease and subfertility continues to be a neglected association in clinical practice.
Competing interests: None declared.
References
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