{"id":798,"date":"2015-02-24T19:44:50","date_gmt":"2015-02-25T00:44:50","guid":{"rendered":"http:\/\/www.mynutriguide.com\/?p=798"},"modified":"2020-07-11T10:39:32","modified_gmt":"2020-07-11T14:39:32","slug":"female-infertility-2","status":"publish","type":"post","link":"https:\/\/glutenfreeworks.com\/health\/female-infertility-2\/","title":{"rendered":"Infertility in Females"},"content":{"rendered":"<h2><a href=\"https:\/\/glutenfreeworks.com\/health\/wp-content\/uploads\/sites\/10\/images-2.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-full wp-image-7297\" src=\"https:\/\/glutenfreeworks.com\/health\/wp-content\/uploads\/sites\/10\/images-2.jpg\" alt=\"images (2)\" width=\"275\" height=\"183\" \/><\/a>What Is Infertility In\u00a0Females?<\/h2>\n<p style=\"text-align: justify\"><span class=\"dropcap\">I<\/span>nfertility in females is characterized by failure to conceive after one year of intercourse.<\/p>\n<p style=\"text-align: justify\">This condition can be frustrating and emotionally upsetting to the parents trying to conceive.<\/p>\n<h2>What Is Infertility In\u00a0Females In Celiac Disease and\/or Gluten Sensitivity?<\/h2>\n<p><!--more--><\/p>\n<ul class=\"cp_check red\">\n<li style=\"text-align: justify\"><strong>Relationship between infertility and celiac disease.<\/strong> Infertility is a symptom of celiac disease, an associated disorder in celiac disease, and a complication of celiac disease.\u00a0It can also be the presenting feature of celiac disease that brings the patient to the doctor.<\/li>\n<li style=\"text-align: justify\"><strong>Relationship between infertility and severity of disease.\u00a0<\/strong>Infertility is not related to the severity of celiac disease,<a href=\"#footnote_1_798\" id=\"identifier_1_798\" class=\"footnote-link footnote-identifier-link\" title=\"Caramaschi P, Biasi D, Carletto A, Randon M, Pacor ML, Bambara LM. Celiac disease and abortion: focusing on a possible relationship. Recenti Progressi in Medicina. Feb 2000;91(2):72-5.\">1<\/a> therefore unexplained subfertility is often undiagnosed in celiac disease. However, consideration of celiac disease can increase the probability of conception and uncomplicated pregnancy with proper treatment.<a href=\"#footnote_2_798\" id=\"identifier_2_798\" class=\"footnote-link footnote-identifier-link\" title=\"Bradley RJ, Rosen MP. Subfertility and gastrointestinal disease: &lsquo;unexplained&rsquo; is often undiagnosed. Obstetrical and Gynecological Survey. Feb 2004;59(2):108-17.\">2<\/a><\/li>\n<li style=\"text-align: justify\"><strong>Relationship between infertility and nutritional deficiencies.\u00a0<\/strong>Infertility may be a consequence of the endocrine derangements caused by selective nutrient deficiencies.<a href=\"#footnote_3_798\" id=\"identifier_3_798\" class=\"footnote-link footnote-identifier-link\" title=\"Rostami K, Steegers EA, Wong WY, Braat DD, Steegers-Theunissen RP. Coeliac disease and reproductive disorders: a neglected association.&nbsp;European Journal of Obstetrics, Gynecology, and Reproductive Biology. Jun 2001;96(2):156-9.\">3<\/a><\/li>\n<li style=\"text-align: justify\"><strong>Relationship between infertility and endometriosis in celiac patients.<\/strong> A\u00a0nationwide study investigating the relationship between celiac disease and endometriosis in 11,000 women with celiac disease found that endometriosis seems to be associated with prior celiac disease. Potential explanations include shared causative factors and inflammation due to celiac disease.<a href=\"#footnote_4_798\" id=\"identifier_4_798\" class=\"footnote-link footnote-identifier-link\" title=\"Stephansson O, Falconer H, Ludvigsson JF. Risk of endometriosis in 11,000 women with celiac disease. Hum Reprod. 2011 Oct;26(10):2896-901. doi: 10.1093\/humrep\/der263.\">4<\/a><\/li>\n<\/ul>\n<ul class=\"cp_bullet red\">\n<li style=\"text-align: justify\">An Italian study found that while celiac disease was diagnosed in 5 of 223 women with endometriosis and in 2 of 246 controls (2.2% versus 0.8%), the rate of infertility in the celiac group was\u00a027.4% compared to control group which was 2.4%).<a href=\"#footnote_5_798\" id=\"identifier_5_798\" class=\"footnote-link footnote-identifier-link\" title=\"Santoro L, Campo S, D&rsquo;Onofrio F, Gallo A, Covino M, Campo V, Palombini G, Santoliquido A, Gasbarrini G, Montalto M. Looking for celiac disease in Italian women with endometriosis: a case control study. Biomed Res Int. 2014;2014:236821. doi: 10.1155\/2014\/236821.\">5<\/a><\/li>\n<li style=\"text-align: justify\">A case report describing diagnosis of celiac disease in a 34 year old women with primary endometriosis emphasizes the role of the celiac disease in women&#8217;s infertility and the possible association between celiac disease and endometriosis. With treatment of a gluten free diet, the woman conceived and bore a healthy infant. Even if the relationship between these two diseases is still unclear and further studies to address this issue are required, more attention from gynecologists is needed, considering that the later this association is diagnosed, the greater the probability of adverse outcomes of health developing.<a href=\"#footnote_6_798\" id=\"identifier_6_798\" class=\"footnote-link footnote-identifier-link\" title=\"Caserta D, Matteucci E, Ralli E, Bordi G, Moscarini M. Celiac disease and endometriosis: an insidious and worrisome association hard to diagnose: a case report. Clin Exp Obstet Gynecol. 2014;41(3):346-8.\">6<\/a><\/li>\n<\/ul>\n<h2>How Prevalent Is Infertility In\u00a0Females In Celiac Disease and\/or Gluten Sensitivity?<\/h2>\n<p style=\"text-align: justify\">There is a high incidence of celiac disease found in women with impaired fertility.<a href=\"#footnote_7_798\" id=\"identifier_7_798\" class=\"footnote-link footnote-identifier-link\" title=\"Sher KS, Mayberry JF. Female fertility, obstetric and gynaecological history in coeliac disease: a case control study. Acta Paediatrica. Supplementum. May 1996;412:76-7.\">7<\/a><\/p>\n<p style=\"text-align: justify\">Celiac disease is more prevalent in women with &#8220;all-cause&#8221; infertility and &#8220;unexplained&#8221; infertility than that in general population. Meta-analysis of literature showed that women with infertility had 3.5 times higher odds of having celiac disease in comparison with control population. Similarly, women with &#8220;unexplained infertility&#8221; had 6 times higher odds of having celiac disease than controls. Of 884 women with infertility, 20 had celiac disease indicating a pooled prevalence of 2.3%. Of 623 women with &#8220;unexplained infertility,&#8221; 20 had celiac disease. The pooled prevalence of celiac disease in women with unexplained infertility was 3.2%.<a href=\"#footnote_8_798\" id=\"identifier_8_798\" class=\"footnote-link footnote-identifier-link\" title=\"Singh P, Arora S, Lal S, Strand TA, Makharia GK. Celiac Disease in Women With Infertility: A Meta-Analysis. J Clin Gastroenterol. 2015 Jan 1.\">8<\/a><\/p>\n<ul class=\"cp_bullet black\">\n<li style=\"text-align: justify\">An Italian study investigating the prevalence of celiac disease among Italian women with endometriosis compared to the general population found that patients with endometriosis showed a largely higher rate of infertility compared to control group (27.4% versus 2.4%).<a href=\"#footnote_9_798\" id=\"identifier_9_798\" class=\"footnote-link footnote-identifier-link\" title=\"Santoro L, Campo S, D&rsquo;Onofrio F, Gallo A, Covino M, Campo V, Palombini G, Santoliquido A, Gasbarrini G, Montalto M. Looking for celiac disease in Italian women with endometriosis: a case control study. Biomed Res Int. 2014;2014:236821. doi: 10.1155\/2014\/236821.\">9<\/a><\/li>\n<li style=\"text-align: justify\">A 2.7% rate was found in Finnish women.<a href=\"#footnote_10_798\" id=\"identifier_10_798\" class=\"footnote-link footnote-identifier-link\" title=\"Collin P, Vilska S, Heinonen PK, Hallstrom O, Pikkarainen P. Infertility and coeliac disease. Gut. Sep 1996;39(3):382-4.\">10<\/a><\/li>\n<li style=\"text-align: justify\">A 1.13% rate was found in Czech women.<a href=\"#footnote_11_798\" id=\"identifier_11_798\" class=\"footnote-link footnote-identifier-link\" title=\"Vancikova Z, Chlumecky V, Sokol D, et al. The serologic screening for celiac disease in the general population (blood donors) and in some high-risk groups of adults (patients with autoimmune diseases, osteoporosis and infertility) in the Czech republic. Folia Microbiologica. 2002;47(6):753-8.\">11<\/a><\/li>\n<li style=\"text-align: justify\">A 3.03% rate was found in Northern Sardinian women.<a href=\"#footnote_12_798\" id=\"identifier_12_798\" class=\"footnote-link footnote-identifier-link\" title=\"Meloni GF, Dessole S, Vargiu N, Tomasi PA, Musumeci S. The prevalence of celiac disease in infertility. Human Reproduction. Nov 1999;14(11):2759-61.\">12<\/a><\/li>\n<li style=\"text-align: justify\">A rate of 3.6% of French women was found.<a href=\"#footnote_13_798\" id=\"identifier_13_798\" class=\"footnote-link footnote-identifier-link\" title=\"Cosnes J, Cosnes C, Cosnes A, et al. Undiagnosed celiac disease in childhood. Gastroenterologie Clinique et Biologique. Jun-Jul 2002;26(6-7)616-23.\">13<\/a><\/li>\n<li style=\"text-align: justify\">A rate of 2.65% was found in Arab women.<a href=\"#footnote_14_798\" id=\"identifier_14_798\" class=\"footnote-link footnote-identifier-link\" title=\"Shamaly H, Mahameed A, Sharony A, Shamir R. Infertility and celiac disease: do we need more than one serological marker?&nbsp;Acta Obstetricia et Gynecologica Scandinavica. Dec 2004;83(12)1184-8.\">14<\/a><\/li>\n<\/ul>\n<h2>What Are The Symptoms Of Infertility In Females?<\/h2>\n<ul class=\"cp_bullet red\">\n<li>Infertility is marked by the inability to become pregnant.<\/li>\n<\/ul>\n<h2>How Does Infertility In\u00a0Females Develop In Celiac Disease and\/or Gluten Sensitivity?<\/h2>\n<ul class=\"cp_check red\">\n<li style=\"text-align: justify\">Although infertility results from unknown pathogenesis,<a href=\"#footnote_15_798\" id=\"identifier_15_798\" class=\"footnote-link footnote-identifier-link\" title=\"Cosnes J, Cosnes C, Cosnes A, et al. Undiagnosed celiac disease in childhood. Gastroenterologie Clinique et Biologique. Jun-Jul 2002;26(6-7)616-23.\">15<\/a> an interaction among specific nutritional deficiencies, endocrine imbalances, and immune disturbances is suspected.<a href=\"#footnote_3_798\" id=\"identifier_16_798\" class=\"footnote-link footnote-identifier-link\" title=\"Rostami K, Steegers EA, Wong WY, Braat DD, Steegers-Theunissen RP. Coeliac disease and reproductive disorders: a neglected association.&nbsp;European Journal of Obstetrics, Gynecology, and Reproductive Biology. Jun 2001;96(2):156-9.\">3<\/a><\/li>\n<li style=\"text-align: justify\">Malnutrition, iron, folate, and zinc deficiencies have all been implicated in infertility,<a href=\"#footnote_16_798\" id=\"identifier_17_798\" class=\"footnote-link footnote-identifier-link\" title=\"Sher KS, Jayanthi V, Probert CS, Stewart CR, Mayberry JF. Infertility, obstetric and gynaecological problems in coeliac sprue. Digestive Diseases. May-Jun 1994;12(3):186-90.\">16<\/a> as well as, calcium, magnesium, omega-6 fatty acids, and vitamin D.<\/li>\n<li style=\"text-align: justify\">Zinc deficiency has been incriminated in infertility in that zinc proteins have been shown to be involved in the transcription and translation of genetic material.<a href=\"#footnote_17_798\" id=\"identifier_18_798\" class=\"footnote-link footnote-identifier-link\" title=\"Jameson S. Zinc status in pregnancy: the effect of zinc therapy on perinatal mortality, prematurity, and placental ablation.&nbsp;Annals of the New York Academy of Sciences. Mar 15, 1993;678:178-92.\">17<\/a><\/li>\n<li style=\"text-align: justify\">Nutritional deficiencies are common before treatment with gluten free diet. In 2013, a study evaluating the nutritional status of 80 Dutch patients with newly diagnosed celiac disease showed 87% to have at least one nutrient deficit. Of these patients, 20% showed deficient levels for folic acid, 67% for zinc deficiency, 46% had decreased iron storage, and 32% had anemia.<a href=\"#footnote_18_798\" id=\"identifier_19_798\" class=\"footnote-link footnote-identifier-link\" title=\"Wierdsma NJ, van Bokhorst-de van der Schueren MA, Berkenpas M, Mulder CJ, van Bodegraven AA. Vitamin and mineral deficiencies are highly prevalent in newly diagnosed celiac disease patients. Nutrients. 2013 Sep 30;5(10):3975-92. doi: 10.3390\/nu5103975.\">18<\/a><\/li>\n<\/ul>\n<h2>Does Infertility In\u00a0Females Respond To Gluten-Free Diet?<\/h2>\n<p style=\"text-align: justify\">Yes. Gluten free diet and correction of deficient dietary elements can lead to a return of fertility.<a href=\"#footnote_16_798\" id=\"identifier_20_798\" class=\"footnote-link footnote-identifier-link\" title=\"Sher KS, Jayanthi V, Probert CS, Stewart CR, Mayberry JF. Infertility, obstetric and gynaecological problems in coeliac sprue. Digestive Diseases. May-Jun 1994;12(3):186-90.\">16<\/a><\/p>\n<p style=\"text-align: justify\">These patients should be made aware of the potential negative effects of active celiac disease in terms of reproductive performances and of the importance of a strict diet to ameliorate their health condition and reproductive health.<a href=\"#footnote_19_798\" id=\"identifier_21_798\" class=\"footnote-link footnote-identifier-link\" title=\"Tersigni C, Castellani R, de Waure C, Fattorossi A, De Spirito M, Gasbarrini A, Scambia G, Di Simone N. Celiac disease and reproductive disorders: meta-analysis of epidemiologic associations and potential pathogenic mechanisms. Hum Reprod Update. 2014 Jul-Aug;20(4):582-93. doi: 10.1093\/humupd\/dmu007.\">19<\/a><\/p>\n<h2 style=\"text-align: justify\">6 Steps To Improve Female Fertility\u00a0In\u00a0Celiac Disease:<\/h2>\n<ul class=\"cp_check green\" style=\"text-align: justify\">\n<li><em><span style=\"color: #800000\"><span class=\"dropcap\"><strong>1<\/strong><\/span><\/span><strong><span style=\"color: #800000\">Remove the Trigger. Maintain a Strict, Nutritious Gluten Free Diet:<\/span><\/strong><\/em><\/li>\n<\/ul>\n<p style=\"text-align: justify\"><div class=\"box shadow\"><div class=\"box-inner-block\"><i class=\"tieicon-boxicon\"><\/i>\n\t\t\t<b>Treatment<\/b>. This condition responds to the complete elimination of gluten, which is the required treatment that improves both female fertility and gut health.<\/p>\n<ul class=\"cp_bullet green\" style=\"text-align: justify\">\n<li>Gut health is the foundation to restore ALL health. Restored health will enable you to maintain a strict gluten free diet, just as other life tasks will be easier.<\/li>\n<li>A strict gluten free diet means removing 100% of wheat, barley, rye and oats from the diet.<\/li>\n<li>Cutting out bread and other obvious sources of gluten is not good enough for recovery. Even 1\/8th teaspoon of flour or bread crumb is enough to sustain the inflammation that is damaging your small intestine, causing increased permeability (leaky gut) and allowing undigested gluten to enter your body where it can damage structures and function, and instigate immune inflammatory responses.<\/li>\n<\/ul>\n<p style=\"text-align: justify\"><strong>Correct Your Individual Nutritional Needs.<\/strong><\/p>\n<ul class=\"cp_bullet green\" style=\"text-align: justify\">\n<li>Eat foods that can replenish missing nutrients. Find them under\u00a0NUTRIENT DEFICIENCIES.<\/li>\n<li>Take nutritional supplements as needed.\u00a0Find them under\u00a0NUTRIENT DEFICIENCIES.<\/li>\n<\/ul>\n<p style=\"text-align: justify\"><strong>Recovery<\/strong>. You should begin to feel better within a week and notice more energy as inflammation subsides and the \u00a0absorbing cells that make up the surface lining of your small intestine are better able to function.<\/p>\n<ul class=\"cp_bullet green\" style=\"text-align: justify\">\n<li>Intestinal lining cells are replaced every 5 days. The healing process is like sunburn where the damaged surface layer of skin sloughs off and is replaced with new normal cells.<\/li>\n<li>Leaky gut normally resolves in two month after starting a gluten free diet and brings about a big improvement in health. Improvement in intestinal permeability precedes morphometric recovery (cell appearance and structure) of the small intestine in celiac disease.<a href=\"#footnote_20_798\" id=\"identifier_22_798\" class=\"footnote-link footnote-identifier-link\" title=\"Cummins AG, Thompson FM, Butler RN, et al. Improvement in intestinal permeability precedes morphometric recovery of the small intestine in coeliac disease.&nbsp;Clinical Science. Apr 2001;100(4):379-86.\">20<\/a><\/li>\n<li>The intestinal lining may take up to a year to heal.\n\t\t\t<\/div><\/div><\/li>\n<\/ul>\n<ul class=\"cp_check green\" style=\"text-align: justify\">\n<li><em><span style=\"color: #800000\"><span class=\"dropcap\"><strong>2<\/strong><\/span><\/span><strong><span style=\"color: #800000\">\u00a0Reduce Inflammation. Foods to Eat and Foods Not to Eat:<\/span><\/strong><\/em><\/li>\n<\/ul>\n<p style=\"text-align: justify\">Because gluten is inflammatory, eliminate OTHER inflammatory foods from your diet to reduce an additive effect to gluten. At the same time, try to eat foods that reduce inflammation (anti-inflammatory).<\/p>\n<p style=\"text-align: justify\"><div class=\"box shadow\"><div class=\"box-inner-block\"><i class=\"tieicon-boxicon\"><\/i>\n\t\t\t<strong>Here Are Major Inflammatory Food Types That Reduce Healing<\/strong>:<\/p>\n<ul class=\"cp_bullet red\" style=\"text-align: justify\">\n<li><strong>Damaging Foods<\/strong>. In susceptible persons, includes corn, dairy (cow), and soy. Lactose, the sugar in any animal milk disrupts intestinal permeability causing leaky gut.<a href=\"#footnote_21_798\" id=\"identifier_23_798\" class=\"footnote-link footnote-identifier-link\" title=\"Farhadi A, Banan A, Fields J, Keshavarzian A. Intestinal barrier: an interface between health and disease.&nbsp;Journal of Gastroenterology and Hepatology. 2003;18:479-91.\">21<\/a><\/li>\n<li><strong>Allergenic Foods<\/strong>. Includes foods that trigger the immune sytem to produce IgE antibodies. Allergy testing is the usual way to discover these offending foods.<\/li>\n<li><strong>Shelf Stable Processed Foods.\u00a0<\/strong>Includes any that contain additives and preservatives. Look for them on the nutrition label of the box or package. Additives and preservatives also disrupt intestinal permeability causing leaky gut.<a href=\"#footnote_21_798\" id=\"identifier_24_798\" class=\"footnote-link footnote-identifier-link\" title=\"Farhadi A, Banan A, Fields J, Keshavarzian A. Intestinal barrier: an interface between health and disease.&nbsp;Journal of Gastroenterology and Hepatology. 2003;18:479-91.\">21<\/a><\/li>\n<li><strong>Fats.<\/strong>\u00a0Limit deep fried foods, trans-fats, saturated fats (animal fat\/butter), and EXCESSIVE omega-6 fatty acid oils like corn oil. Rancid fats, sodium caprate (a medium chain fat), and sucrose monester fatty acid (a food grade surfactant) induce significant disruption of the intestinal barrier that causes leaky gut.<a href=\"#footnote_21_798\" id=\"identifier_25_798\" class=\"footnote-link footnote-identifier-link\" title=\"Farhadi A, Banan A, Fields J, Keshavarzian A. Intestinal barrier: an interface between health and disease.&nbsp;Journal of Gastroenterology and Hepatology. 2003;18:479-91.\">21<\/a>.<\/li>\n<li><strong>Excessive Refined White Flours\u00a0<\/strong>(bran layer removed)<strong>.\u00a0<\/strong>Includes\u00a0products made from them such as cookies, bread, cakes, pies.\u00a0Bran contains the vitamins and minerals that metabolize grains and slows the otherwise rapid entry of sugar from their digestion into the bloodstream.\u00a0Also disrupt intestinal permeability causing leaky gut.<a href=\"#footnote_21_798\" id=\"identifier_26_798\" class=\"footnote-link footnote-identifier-link\" title=\"Farhadi A, Banan A, Fields J, Keshavarzian A. Intestinal barrier: an interface between health and disease.&nbsp;Journal of Gastroenterology and Hepatology. 2003;18:479-91.\">21<\/a><\/li>\n<li><strong>Refined Sugars.\u00a0<\/strong>\u00a0Includes white sugar, corn fructose and high fructose corn syrup.<\/li>\n<li><strong>Certain Spices<\/strong>. Includes paprika and cayenne pepper which disrupt intestinal permeability causing leaky gut.<a href=\"#footnote_21_798\" id=\"identifier_27_798\" class=\"footnote-link footnote-identifier-link\" title=\"Farhadi A, Banan A, Fields J, Keshavarzian A. Intestinal barrier: an interface between health and disease.&nbsp;Journal of Gastroenterology and Hepatology. 2003;18:479-91.\">21<\/a><\/li>\n<li><strong>Alcohol and Caffeine<\/strong>. Disrupt intestinal permeability causing leaky gut.<a href=\"#footnote_21_798\" id=\"identifier_28_798\" class=\"footnote-link footnote-identifier-link\" title=\"Farhadi A, Banan A, Fields J, Keshavarzian A. Intestinal barrier: an interface between health and disease.&nbsp;Journal of Gastroenterology and Hepatology. 2003;18:479-91.\">21<\/a><\/li>\n<li><strong>Cocoa and Black\u00a0Tea<\/strong>\u00a0increase blood sugar.<\/li>\n<li><strong>Rosemary.<\/strong>\u00a0Increases blood sugar levels and should not be used by persons with insulin resistance or diabetes. \n\t\t\t<\/div><\/div><\/li>\n<\/ul>\n<p style=\"text-align: justify\"><div class=\"box shadow\"><div class=\"box-inner-block\"><i class=\"tieicon-boxicon\"><\/i>\n\t\t\t<strong>Here Are Important Anti-Inflammatory Food Types to Promote Health<\/strong>:<\/p>\n<ul class=\"cp_bullet green\" style=\"text-align: justify\">\n<li><strong>Fruits<\/strong>.\u00a0Contain ample amounts of vitamins, minerals and phytochemicals which are\u00a0naturally occuring components in plants that detoxify toxins, carcinogens (reducing the risk by 50%) and mutagens.<\/li>\n<li><strong>Non-Starchy Vegetables.<\/strong>\u00a0Support intestinal integrity and provide ample amounts of vitamins, minerals and phytochemicals. Includes green leafy vegetables such as lettuce and kale, also onion, broccoli, garlic, and others.<\/li>\n<li><strong>High Quality Complex Carbohydrates<\/strong>. Provide vitamins, minerals, and fiber while boosting serotonin levels to help you relax and feel calm. Includes whole grains, legumes, and root vegetables such as carrots, parsnips, sweet potatoes, turnips, red beets, and others.<\/li>\n<li><strong>Antioxidants<\/strong>. Protect the body from inflammatory oxidant molecules that continually occur and\u00a0help us handle stress and reduce irritability. Includes vitamin C-containing foods such as lemon, grapefruit, apricot, Brussels sprouts and strawberries, and others. Also, includes vitamin E-containing foods such as\u00a0nuts, seeds, avocado, olive oil, and others. Cocoa is good, too.<\/li>\n<li><strong>Omega-3 Fatty Acids<\/strong>. Balance opposing omega-6 fatty acids and bad fats. Fish sources includes tuna, salmon, cod, and others. Plants sources include flax, chia seeds, canola oil, and others.<\/li>\n<li><strong>Probiotics.\u00a0<\/strong>Supply normal microbes needed for colon health and health of the body such as these fermented foods: yogurt, kefir, and unpasteurized apple cider vinegar.<\/li>\n<li><strong>Prebiotics\/ High Fiber Foods<\/strong>. \u00a0Food with fiber keeps our population of colonic microbes healthy.<\/li>\n<li><strong>Protective Herbs and Spices<\/strong>. \u00a0See below #6 below for examples.\n\t\t\t<\/div><\/div><\/li>\n<\/ul>\n<ul class=\"cp_check green\" style=\"text-align: justify\">\n<li><em><span style=\"color: #800000\"><strong><span class=\"dropcap\">3<\/span>\u00a0Information Sheet You Can Take to Your Doctor or Other Health Professional:<\/strong><\/span><\/em><\/li>\n<\/ul>\n<p style=\"text-align: justify\">Click here.<\/p>\n<ul class=\"cp_check green\" style=\"text-align: justify\">\n<li><span style=\"color: #800000\"><strong><em><span class=\"dropcap\">4<\/span>\u00a0Manage Your Medications\u00a0Safely<\/em>:<\/strong><\/span><\/li>\n<\/ul>\n<p style=\"text-align: justify\"><div class=\"box shadow\"><div class=\"box-inner-block\"><i class=\"tieicon-boxicon\"><\/i>\n\t\t\t\n<p style=\"text-align: justify\">Certain medications deplete folic acid, vitamin D, calcium,\u00a0magnesium, zinc, iron, and omega-6 fatty acids that promote infertility. Ask your doctor or pharmacist about this possible adverse effect if you are taking any of the drugs listed below.\u00a0<strong>Do not stop prescribed medications without supervision.<\/strong><\/p>\n<p style=\"text-align: justify\">This is not a complete listing.<\/p>\n<p style=\"text-align: justify\"><strong>ANTACIDS \/ ULCER MEDICATIONS<\/strong><\/p>\n<ul class=\"cp_bullet blue\" style=\"text-align: justify\">\n<li>Pepcid\u00ae, Tagamet\u00ae, Zantac\u00ae deplete Calcium, Folic Acid, Iron, Vitamin D, Zinc, Magnesium.<\/li>\n<li>Magnesium and Aluminum Antacid preparations (Gaviscon\u00ae, Maalox\u00ae, Mylanta\u00ae) deplete\u00a0Calcium, Folic Acid, Iron, Vitamin D, Zinc, Magnesium.<\/li>\n<li>Alka Seltzer\u00ae, Baking Soda deplete Folic Acid, Magnesium.<\/li>\n<\/ul>\n<p style=\"text-align: justify\"><strong>ANTIBIOTICS\u00a0<\/strong>disrupt intestinal permeability which complicates celiac disease.<\/p>\n<ul class=\"cp_bullet blue\" style=\"text-align: justify\">\n<li>Gentomycin, Neomycin, Streptomycin, Cephalosporins, Penicillins\u00a0deplete\u00a0B Vitamins.<\/li>\n<li>\u00a0Tetracyclines deplete Calcium, Magnesium, Iron, Zinc.<\/li>\n<li>Cipro depletes Coenzyme Q10, Zinc.<\/li>\n<li>Penicillins deplete Folic Acid.<a href=\"#footnote_22_798\" id=\"identifier_29_798\" class=\"footnote-link footnote-identifier-link\" title=\"https:\/\/umm.edu\/health\/medical\/altmed\/depletion\/antibiotic-medications-penicillin-derivatives.\">22<\/a><\/li>\n<li>Erythromycin\u00a0depletes Folic Acid..<a href=\"#footnote_23_798\" id=\"identifier_30_798\" class=\"footnote-link footnote-identifier-link\" title=\"http:\/\/umm.edu\/health\/medical\/altmed\/depletion\/antibiotic-medications-macrolides\">23<\/a><\/li>\n<\/ul>\n<p style=\"text-align: justify\"><strong>ANTI-INFLAMMATORIES<\/strong>\u00a0disrupt intestinal permeability which complicates celiac disease.<\/p>\n<ul class=\"cp_bullet blue\" style=\"text-align: justify\">\n<li>Corticosteroids (Prednisone, Medrol\u00ae, Aristocort\u00ae, Decadron) deplete Calcium, Vitamin D, Magnesium, Zinc, Folic Acid.<\/li>\n<li>NSAIDS (Motrin\u00ae, Aleve\u00ae, Advil\u00ae, Anaprox\u00ae, Dolobid\u00ae, Feldene\u00ae, Naprosyn\u00ae and others) deplete\u00a0Folic acid.<\/li>\n<li>Aspirin and Salicylates deplete\u00a0Calcium, Folic acid, Iron.<\/li>\n<\/ul>\n<p style=\"text-align: justify\"><strong>ANTICONVULSANTS<\/strong><\/p>\n<ul class=\"cp_bullet blue\" style=\"text-align: justify\">\n<li>Phenobarbital and Barbituates; and Dilantin\u00ae, Tegretol\u00ae, Mysoline\u00ae, Depakane\/Depacon\u00ae deplete\u00a0Calcium, Vitamin D, Folic Acid, Zinc.<\/li>\n<\/ul>\n<p style=\"text-align: justify\"><strong>ANTIVIRAL AGENTS<\/strong><\/p>\n<ul class=\"cp_bullet blue\" style=\"text-align: justify\">\n<li>Zidovudine (Retrovir\u00ae, AZT and other related drugs) deplete Zinc.<\/li>\n<li>Foscanet depletes Calcium, Magnesium.<strong>\u00a0<\/strong><\/li>\n<\/ul>\n<p style=\"text-align: justify\"><strong>BRONCHODILATORS<\/strong><\/p>\n<ul class=\"cp_bullet blue\" style=\"text-align: justify\">\n<li>Inhaled corticosteroid inhalers (Flovent, Pulmicort and others) that are breathed in on a daily basis\u00a0as a long term therapy to reduce inflammation in airways deplete Calcium, Vitamin D, and B vitamins.<\/li>\n<li>Albuterol inhalers that\u00a0are breathed in on a daily basis as a long term therapy and also for quick relief as rescue inhalers to open airways depletes Magnesium, Calcium.<\/li>\n<\/ul>\n<p style=\"text-align: justify\"><strong>CARDIOVASCULAR DRUGS<\/strong><\/p>\n<ul class=\"cp_bullet blue\" style=\"text-align: justify\">\n<li>Antihypertensives (Catapres\u00ae, Aldomet) deplete Zinc.<\/li>\n<li>ACE Inhibitors (Capoten\u00ae, Vasotec\u00ae, Monopril\u00ae and others) deplete Zinc.<\/li>\n<\/ul>\n<p style=\"text-align: justify\"><strong>CHOLESTEROL DRUGS<\/strong><\/p>\n<ul class=\"cp_bullet blue\" style=\"text-align: justify\">\n<li>Colestid\u00ae and Questran\u00ae deplete Vitamin D, Folic Acid, Iron.<\/li>\n<\/ul>\n<p style=\"text-align: justify\"><strong>DIABETIC DRUGS\u00a0<\/strong><\/p>\n<ul class=\"cp_bullet blue\" style=\"text-align: justify\">\n<li>Metformin\u00ae depletes\u00a0Coenzyme Folic acid.<\/li>\n<\/ul>\n<p style=\"text-align: justify\"><strong>DIURETICS<\/strong><\/p>\n<ul class=\"cp_bullet blue\" style=\"text-align: justify\">\n<li>Thiazide Diuretics (Hydrochlorothiazide, Enduron\u00ae, Diuril\u00ae, Lozol\u00ae, Zaroxolyn\u00ae, Hygroton\u00ae and others) deplete Magnesium, Zinc.<\/li>\n<li>Loop Diuretics (Lasix\u00ae, Bumex\u00ae, Edecrin\u00ae) deplete Calcium, Magnesium, Zinc.<\/li>\n<li>Potassium Sparing Diuretics (Midamor\u00ae, Aldactone\u00ae, Dyrenium\u00ae and others) deplete\u00a0Calcium, Folic Acid, Zinc.<\/li>\n<\/ul>\n<p style=\"text-align: justify\"><strong>FEMALE HORMONES<\/strong>\u00a0disrupt intestinal permeability which complicate celiac disease.<\/p>\n<ul class=\"cp_bullet blue\" style=\"text-align: justify\">\n<li>Oral Contraceptives (Norinyl\u00ae, Ortho-Novum\u00ae, Triphasil\u00ae, and others) deplete Folic Acid, Magnesium, Zinc.<\/li>\n<\/ul>\n<p style=\"text-align: justify\"><strong>LAXATIVES<\/strong><\/p>\n<ul class=\"cp_bullet blue\" style=\"text-align: justify\">\n<li>Metamucil, FiberCon, Citrucel, Colace, Glycolax, Milk of magnesia, Dulcolax deplete: Vitamin D, Calcium.<\/li>\n<\/ul>\n<p style=\"text-align: justify\"><strong>WEIGHT LOSS DRUGS THAT BIND FAT\u00a0<\/strong>also interfere with absorption of some nutrients.<\/p>\n<ul class=\"cp_bullet blue\" style=\"text-align: justify\">\n<li>Zenicol (Orlistat\u00ae) depletes Vitamin D.<\/li>\n<\/ul>\n<p style=\"text-align: justify\">\n\t\t\t<\/div><\/div>\n<ul class=\"cp_check green\" style=\"text-align: justify\">\n<li><em><span style=\"color: #800000\"><strong><span class=\"dropcap\">5<\/span>Nutritional Supplements To Help Correct Deficiencies:<\/strong><\/span><\/em><\/li>\n<\/ul>\n<p style=\"text-align: justify\"><div class=\"box shadow\"><div class=\"box-inner-block\"><i class=\"tieicon-boxicon\"><\/i>\n\t\t\t\n<p style=\"text-align: justify\">The type and quantity of nutritional supplements that may be needed depend on which nutrients are deficient.<\/p>\n<ul class=\"cp_bullet orange\" style=\"text-align: justify\">\n<li>Multivitamin\/mineral combination that provides 100% once a day is useful to improve overall nutrient levels. This is a safe dose, but always check with your doctor to avoid interactions with medications.<\/li>\n<li>Calcium citrate is the best absorbed of calcium supplements. Calcium carbonate is a poor choice.<\/li>\n<li>Vitamin D3 as prescribed following blood test for status.<\/li>\n<li>Chelated magnesium\u00a0\u00a0as prescribed but do not take at same time as calcium because they compete for absorption.<\/li>\n<li>Zinc\u00a0as prescribed following blood test for status.<\/li>\n<li>Ferrous fumarate or gluconate\u00a0as prescribed following blood test for iron status.<\/li>\n<\/ul>\n<p style=\"text-align: justify\"><strong>Storage Note<\/strong>:\u00a0<em>Store container tightly sealed, away from heat, moisture and direct light to avoid loss of potency. That is, in a safe kitchen cabinet &#8211; not in the bathroom or on the kitchen table<\/em>.\n\t\t\t<\/div><\/div>\n<ul class=\"cp_check green\" style=\"text-align: justify\">\n<li><span style=\"color: #800000\"><em><strong><span class=\"dropcap\">6<\/span>Manage Natural Remedies:\u00a0<\/strong><\/em><\/span><\/li>\n<\/ul>\n<p style=\"text-align: justify\"><div class=\"box shadow\"><div class=\"box-inner-block\"><i class=\"tieicon-boxicon\"><\/i>\n\t\t\t<strong>Hydration<\/strong>:<\/p>\n<ul class=\"cp_bullet green\" style=\"text-align: justify\">\n<li>Eight glasses of water are recommended per day unless there is a contraindication such as kidney or heart disease. The Institute of Medicine recommends approximately 2.7 liters (91 ounces) of total water, from all beverages and foods, each day for women and 3.7 liters (125 ounces) daily of total water for men.<\/li>\n<li>If you are thirsty, drink water. Add fresh, squeezed lemon to water. Lemon is anti-inflammatory, alkalizing and provides vitamin C.<\/li>\n<li>Hydration Test: Urine should be pale yellow. Fingertips should be plump, without pruning but this may not be reliable when fingers are swollen with edema. Lips should be plump, without puckering. The feeling of thirst can be unreliable.<\/li>\n<li>What is wrong with soda, coffee, tea, and alcohol? These drinks are dehydrating, increase acid, and deplete nutrients.\n\t\t\t<\/div><\/div><\/li>\n<\/ul>\n<p style=\"text-align: justify\"><div class=\"box shadow\"><div class=\"box-inner-block\"><i class=\"tieicon-boxicon\"><\/i>\n\t\t\t<strong>Carminatives.\u00a0<\/strong>The following \u00a0anti-inflammatory\u00a0plant sources called carminitives help heal the digestive tract. They also tone the digestive muscles which improves peristalsis, thus aiding in the expulsion of gas from the stomach and intestine to relieve digestive colic and gastric discomfort.<\/p>\n<p style=\"text-align: justify\"><strong>Carminative Food Remedies<\/strong>:<\/p>\n<ul class=\"cp_bullet green\" style=\"text-align: justify\">\n<li>Raspberry.<\/li>\n<li>Carrot is also a cleansing digestive tonic.<\/li>\n<li>Grape is also bile stimulating and a cleansing remedy for sluggish digestion and laxative.<\/li>\n<li>Redbeets also stimulate and improve digestion and are easily digested.<\/li>\n<li>Cabbage also stimulates and improves digestion and is also a liver decongestant.<\/li>\n<li>Lettuce also stimulates and improves digestion and is also an alterative, meaning it improves the function of organs involved with the digestion and excretion of waste products to bring about a gradual change.<\/li>\n<li>Potatoes are antispasmodic (due to atropine like properties) and a liver remedy.<\/li>\n<\/ul>\n<p style=\"text-align: justify\"><strong>Carminative Herb Remedies:<\/strong><\/p>\n<ul class=\"cp_bullet green\" style=\"text-align: justify\">\n<li>Sage is also a digestive, astringent, bile stimulant and energy tonic that heals the mucosa. \u00a0Drink as tea or use in cooking.<\/li>\n<li>Chamomile, lemon balm, and fennel, (as a tea) also help relieve nervous tension.<\/li>\n<li>Parsley also relieves indigestion.<\/li>\n<li>Rosemary as a tea and in cooking also is a nervous system tonic for stress and fatigue, bile stimulant, and can relieve headaches and indigestion. However, because it increases blood sugar levels, it should not be used by persons with insulin resistance or diabete.<\/li>\n<li>Thyme is also soothing remedy useful for stimulating digestion of rich, fatty foods.<\/li>\n<\/ul>\n<p style=\"text-align: justify\"><strong>Carminative Spice Remedies:<\/strong><\/p>\n<ul class=\"cp_bullet green\" style=\"text-align: justify\">\n<li>Cloves are also antispasmodic.<\/li>\n<li>Nutmeg is also useful for indigestion.<\/li>\n<li>Ginger.\n\t\t\t<\/div><\/div><\/li>\n<\/ul>\n<p style=\"text-align: justify\"><div class=\"box shadow\"><div class=\"box-inner-block\"><i class=\"tieicon-boxicon\"><\/i>\n\t\t\t<strong>Exercise Helps<\/strong>:<\/p>\n<p style=\"text-align: justify\">Exercise improves circulation and rids the body of toxins.<\/p>\n<ul class=\"cp_bullet green\" style=\"text-align: justify\">\n<li>Walking is aerobic exercise that reconditions the whole body to improve stamina.\u00a0Read more about<a href=\"https:\/\/glutenfreeworks.com\/health\/2014\/07\/08\/fitness-guide\/\">\u00a0Exercise and Fitness<\/a>.<\/li>\n<li>Weight training builds muscle.\u00a0Read more about\u00a0<a href=\"https:\/\/glutenfreeworks.com\/health\/2014\/07\/08\/fitness-guide\/\">Exercise and Fitness<\/a>.<\/li>\n<li>Stretching improves flexibilty.\u00a0Read more about\u00a0<a href=\"https:\/\/glutenfreeworks.com\/health\/2014\/07\/08\/fitness-guide\/\">Exercise and Fitness<\/a>.<\/li>\n<\/ul>\n<p style=\"text-align: justify\"><strong>Note<\/strong>: Exercise is important, but the amount and type of exercise undertaken depends on your health. Your first priority is to heal. \n\t\t\t<\/div><\/div>\n<h2 style=\"text-align: justify\">What Do Medical Research Studies Tell About Female Infertility In Celiac Disease and\/or Gluten Sensitivity?<\/h2>\n<h4><strong>RESEARCH STUDY SUMMARIES<\/strong><\/h4>\n<p style=\"text-align: justify\"><strong>\u201cCeliac Disease in Women With Infertility: A Meta-Analysis.\u201d<\/strong> This study investigating the association between celiac disease and infertility by means of meta-analysis of a literature search found that celiac disease is more prevalent in women with &#8220;all-cause&#8221; infertility and &#8220;unexplained&#8221; infertility than that in general population.<\/p>\n<p style=\"text-align: justify\">Diagnosis of celiac disease was based on positive serology and biopsies showing villous atrophy. Data were extracted about celiac disease patients in 3 groups-women with infertility (including unexplained infertility), unexplained infertility, and controls. Pooled odds ratio (OR) and prevalence, with 95% confidence intervals (CI), were calculated.<\/p>\n<p style=\"text-align: justify\">Of 105 relevant studies, 5 studies were included for calculation of pooled OR. Four additional studies, where data on controls were not available, were also considered for calculation of pooled prevalence of celiac disease. Women with infertility had 3.5 times higher odds of having celiac disease in comparison with control population (OR=3.5; 95% CI, 1.3-9; P&lt;0.01). Similarly, women with &#8220;unexplained infertility&#8221; had 6 times higher odds of having celiac disease than controls (OR=6; 95% CI, 2.4-14.6). Of 884 women with infertility, 20 had celiac disease indicating a pooled prevalence of 2.3% (95% CI, 1.4-3.5). Of 623 women with &#8220;unexplained infertility,&#8221; 20 had celiac disease. The pooled prevalence of celiac disease in women with unexplained infertility was 3.2 (95% CI, 2-4.9).<a href=\"#footnote_8_798\" id=\"identifier_31_798\" class=\"footnote-link footnote-identifier-link\" title=\"Singh P, Arora S, Lal S, Strand TA, Makharia GK. Celiac Disease in Women With Infertility: A Meta-Analysis. J Clin Gastroenterol. 2015 Jan 1.\">8<\/a><\/p>\n<p style=\"text-align: justify\"><strong>\u201cCeliac disease and reproductive disorders: meta-analysis of epidemiologic associations and potential pathogenic mechanisms.\u201d<\/strong> This study, which was undertaken to better define the risk of celiac disease in patients with reproductive disorders, as well as, the risk in known celiac disease patients of developing obstetric complications found that patients with unexplained infertility were found to have a significantly higher risk of celiac disease than the general population.<\/p>\n<p style=\"text-align: justify\">An extensive literature search of Medline and Embase databases was performed. Odds ratio (OR) and relative risk (RR) with 95% confidence intervals (95% CI) were used in order to combine data from case-control and cohort studies, respectively.<\/p>\n<p style=\"text-align: justify\">Patients with unexplained infertility, recurrent miscarriage or intrauterine growth restriction (IUGR) were found to have a significantly higher risk of celiac disease than the general population. The OR for celiac disease was 5.06 (95% CI 2.13-11.35) in patients with unexplained infertility, 5.82 (95% CI 2.30-14.74) in women experiencing recurrent miscarriage and 8.73 (95% CI 3.23-23.58) in patients with IUGR. \u00a0However, the increased risk is significantly reduced by a gluten-free diet.<\/p>\n<p style=\"text-align: justify\">These patients should therefore be made aware of the potential negative effects of active celiac disease also in terms of reproductive performances, and of the importance of a strict diet to ameliorate their health condition and reproductive health.<a href=\"#footnote_19_798\" id=\"identifier_32_798\" class=\"footnote-link footnote-identifier-link\" title=\"Tersigni C, Castellani R, de Waure C, Fattorossi A, De Spirito M, Gasbarrini A, Scambia G, Di Simone N. Celiac disease and reproductive disorders: meta-analysis of epidemiologic associations and potential pathogenic mechanisms. Hum Reprod Update. 2014 Jul-Aug;20(4):582-93. doi: 10.1093\/humupd\/dmu007.\">19<\/a><\/p>\n<p style=\"text-align: justify\"><strong>\u201cLooking for celiac disease in Italian women with endometriosis: a case control study.\u201d<\/strong> This study investigating the prevalence of celiac disease among Italian women with endometriosis compared to the general population found that patients with endometriosis showed a largely higher rate of infertility compared to control group (27.4% versus 2.4%) and confirmed that in the Italian population an increased prevalence of celiac disease among patients with endometriosis is found.<\/p>\n<p style=\"text-align: justify\">Consecutive women with a laparoscopic and histological confirmed diagnosis of endometriosis were enrolled; female nurses at this institution, without a known history of endometriosis, were enrolled as controls. IgA endomysial and tissue transglutaminase antibodies measurement and serum total IgA dosage were performed in both groups. An upper digestive endoscopy with an intestinal biopsy was performed in case of antibodies positivity. Presence of infertility, miscarriage, coexistence of other autoimmune diseases, and family history of autoimmune diseases was also investigated in all subjects.<\/p>\n<p style=\"text-align: justify\">Celiac disease was diagnosed in 5 of 223 women with endometriosis and in 2 of 246 controls (2.2% versus 0.8%).<a href=\"#footnote_9_798\" id=\"identifier_33_798\" class=\"footnote-link footnote-identifier-link\" title=\"Santoro L, Campo S, D&rsquo;Onofrio F, Gallo A, Covino M, Campo V, Palombini G, Santoliquido A, Gasbarrini G, Montalto M. Looking for celiac disease in Italian women with endometriosis: a case control study. Biomed Res Int. 2014;2014:236821. doi: 10.1155\/2014\/236821.\">9<\/a><\/p>\n<p style=\"text-align: justify\"><b>\u201cVitamin and mineral deficiencies are highly prevalent in newly diagnosed celiac disease patients.\u201d<\/b> This study aiming to assess the nutritional and vitamin\/mineral status of current &#8220;early diagnosed&#8221; untreated adult CD-patients in the Netherlands found that vitamin\/mineral deficiencies are still common in newly &#8220;early diagnosed&#8221; CD-patients, even though the prevalence of obesity at initial diagnosis is rising. Eighty (80) consecutively newly diagnosed adult CD-patients were included and a comparable sample of 24 healthy Dutch subjects was added to compare vitamin concentrations.\u00a0Some of the CD patients reported to have used vitamin and mineral supplements before diagnosis of CD was made: 18 (22.5%) a multivitamin, folic acid or vitamin B-complex, 7 (8.8%) iron supplements and 14 (17.5%) a calcium supplement.<\/p>\n<p style=\"text-align: justify\">Nutritional status and serum concentrations were determined \u00a0(before prescribing gluten free diet). Almost all CD-patients (87%) had at least one value below the lower limit of reference. Specifically, 20%\u00a0showed deficient levels\u00a0for\u00a0folic acid,\u00a067%\u00a0for zinc deficiency, 46% had decreased iron storage, and 32% had anaemia.\u00a0Overall, 17% were malnourished (&gt;10% undesired weight loss), 22% of the women were underweight (Body Mass Index (BMI) &lt; 18.5), and 29% of the patients were overweight (BMI &gt; 25). Vitamin deficiencies were barely seen in healthy controls, with the exception of vitamin B\u2081\u2082. Vitamin\/mineral deficiencies were counter-intuitively not associated with a (higher) grade of histological intestinal damage or (impaired) nutritional status. Extensive nutritional assessments seem warranted to guide nutritional advices and follow-up in CD treatment.<a href=\"#footnote_18_798\" id=\"identifier_34_798\" class=\"footnote-link footnote-identifier-link\" title=\"Wierdsma NJ, van Bokhorst-de van der Schueren MA, Berkenpas M, Mulder CJ, van Bodegraven AA. Vitamin and mineral deficiencies are highly prevalent in newly diagnosed celiac disease patients. Nutrients. 2013 Sep 30;5(10):3975-92. doi: 10.3390\/nu5103975.\">18<\/a><\/p>\n<p style=\"text-align: justify\"><strong>\u201cRisk of endometriosis in 11,000 women with celiac disease.\u201d<\/strong> This nationwide study investigating the relationship between celiac disease and endometriosis found that endometriosis seems to be associated with prior celiac disease. Potential explanations include shared etiological factors and inflammation caused by celiac disease.<\/p>\n<p style=\"text-align: justify\">Researchers identified 11 097 women with celiac disease (Marsh 3: villous atrophy) through biopsy data from all 28 pathology departments in Sweden. Biopsies had been performed between 1973 and 2008. Data on inpatient and outpatient diagnoses of endometriosis were retrieved from the National Patient Register. Cox regression was used to estimate the hazard ratios (HRs) for endometriosis in women with celiac disease to compare with those in 54 992 age-matched control women.<\/p>\n<p style=\"text-align: justify\">During the follow-up, 118 individuals with celiac disease and 399 matched controls developed endometriosis. Hence, patients with celiac disease were at increased risk of subsequent endometriosis [HR = 1.39; 95% confidence interval (CI) = 1.14-1.70]. The absolute risk of endometriosis in patients with celiac disease was 112\/100,000 person-years with an excess risk of 31\/100,000. Risk estimates were highest in the first year after diagnosis (HR = 1.49; 95% CI = 0.83-2.67) and gradually decreased (&gt;5 years after celiac disease diagnosis, HR = 1.33; 95% CI = 1.00-1.79).<a href=\"#footnote_4_798\" id=\"identifier_35_798\" class=\"footnote-link footnote-identifier-link\" title=\"Stephansson O, Falconer H, Ludvigsson JF. Risk of endometriosis in 11,000 women with celiac disease. Hum Reprod. 2011 Oct;26(10):2896-901. doi: 10.1093\/humrep\/der263.\">4<\/a><\/p>\n<p style=\"text-align: justify\"><strong>\u201cThe serologic screening for celiac disease in the general population (blood donors) and in some high-risk groups of adults (patients with autoimmune diseases, osteoporosis and infertility) in the Czech republic.\u201d<\/strong>\u00a0This study investigating prevalence of infertility in healthy blood donors and in high-risk groups of adults demonstrated that 1.13% of 365 women with infertility considered as immunologically mediated were found to be positive in screening IgA and IgG AGA (anti-gliadin) and IgA anti-tTG (transglutaminase) as step 1 and IgA AGA and\/or IgA tTG and EMA (endomysium) as step 2.<a href=\"#footnote_11_798\" id=\"identifier_36_798\" class=\"footnote-link footnote-identifier-link\" title=\"Vancikova Z, Chlumecky V, Sokol D, et al. The serologic screening for celiac disease in the general population (blood donors) and in some high-risk groups of adults (patients with autoimmune diseases, osteoporosis and infertility) in the Czech republic. Folia Microbiologica. 2002;47(6):753-8.\">11<\/a><\/p>\n<p style=\"text-align: justify\"><strong>\u201cUndiagnosed celiac disease in childhood.\u201d<\/strong> This study investigating the proportion of adult patients with celiac disease who had had undiagnosed symptoms during childhood and the consequences of such diagnostic delay demonstrated low fertility and short stature correlated with duration of symptoms before diagnosis.<a href=\"#footnote_13_798\" id=\"identifier_37_798\" class=\"footnote-link footnote-identifier-link\" title=\"Cosnes J, Cosnes C, Cosnes A, et al. Undiagnosed celiac disease in childhood. Gastroenterologie Clinique et Biologique. Jun-Jul 2002;26(6-7)616-23.\">13<\/a><\/p>\n<p style=\"text-align: justify\"><strong>\u201cThe prevalence of celiac disease in infertility.\u201d<\/strong> This study investigating the prevalence of celiac disease in couples being evaluated for infertility compared with the known prevalence of silent celiac disease demonstrated higher prevalence.<a href=\"#footnote_12_798\" id=\"identifier_38_798\" class=\"footnote-link footnote-identifier-link\" title=\"Meloni GF, Dessole S, Vargiu N, Tomasi PA, Musumeci S. The prevalence of celiac disease in infertility. Human Reproduction. Nov 1999;14(11):2759-61.\">12<\/a><\/p>\n<p style=\"text-align: justify\"><strong>\u201cFemale fertility, obstetric and gynaecological history in coeliac disease: a case control study.\u201d<\/strong> This study investigating the incidence of infertility demonstrated that patients with celiac disease are subfertile. Overall difference in fertility is due to relative infertility prior to diagnosis, and is corrected by a Gluten Free Diet.<a href=\"#footnote_24_798\" id=\"identifier_39_798\" class=\"footnote-link footnote-identifier-link\" title=\"Sher KS, Mayberry JF. Female fertility, obstetric and gynaecological history in coeliac disease: a case control study. Acta Paediatrica. Supplementum. May 1996;412:76-7.\">24<\/a><\/p>\n<p style=\"text-align: justify\"><strong>\u201cInfertility and coeliac disease.&#8221;<\/strong>\u00a0 This study investigating the incidence of subclinical forms of celiac disease in women with decreased fertility demonstrated higher incidence in silent deliac disease.<a href=\"#footnote_25_798\" id=\"identifier_40_798\" class=\"footnote-link footnote-identifier-link\" title=\"Collin P, Vilska S, Heinonen PK, Hallstrom O, Pikkarainen P. Infertility and coeliac disease. Gut. Sep 1996;39(3):382-4.\">25<\/a><\/p>\n<h4 style=\"text-align: justify\"><strong>CASE REPORT SUMMARIES<\/strong><\/h4>\n<p style=\"text-align: justify\"><strong>\u201cCeliac disease and endometriosis: an insidious and worrisome association hard to diagnose: a case report.\u201d<\/strong> This case report describes diagnosing celiac disease in a 34-year-old patient who presented to the authors&#8217; observation with primary infertility. Formerly she was treated for endometriosis and the diagnosis of celiac disease was delayed. A favorable clinical and serological response following a gluten-free-diet was achieved and a successful pregnancy was obtained.<\/p>\n<p style=\"text-align: justify\">This case report emphasizes the role of the celiac disease in women&#8217;s infertility and the possible association between celiac disease and endometriosis. Even if the relationship between these two diseases is still unclear and further studies to address this issue are required, more attention from gynecologists is needed, considering that the later this association is diagnosed, the greater the probability of adverse outcomes of health developing.<a href=\"#footnote_6_798\" id=\"identifier_41_798\" class=\"footnote-link footnote-identifier-link\" title=\"Caserta D, Matteucci E, Ralli E, Bordi G, Moscarini M. Celiac disease and endometriosis: an insidious and worrisome association hard to diagnose: a case report. Clin Exp Obstet Gynecol. 2014;41(3):346-8.\">6<\/a><\/p>\n<ol class=\"footnotes\"><li id=\"footnote_1_798\" class=\"footnote\">Caramaschi P, Biasi D, Carletto A, Randon M, Pacor ML, Bambara LM. Celiac disease and abortion: focusing on a possible relationship. <em>Recenti Progressi in Medicina<\/em>. Feb 2000;91(2):72-5.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_1_798\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_2_798\" class=\"footnote\">Bradley RJ, Rosen MP. Subfertility and gastrointestinal disease: \u2018unexplained\u2019 is often undiagnosed. <em>Obstetrical and Gynecological Surve<\/em>y. Feb 2004;59(2):108-17.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_2_798\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_3_798\" class=\"footnote\">Rostami K, Steegers EA, Wong WY, Braat DD, Steegers-Theunissen RP. Coeliac disease and reproductive disorders: a neglected association.\u00a0<em>European Journal of Obstetrics, Gynecology, and Reproductive Biology<\/em>. Jun 2001;96(2):156-9.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_3_798\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_16_798\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_4_798\" class=\"footnote\">Stephansson O, Falconer H, Ludvigsson JF. Risk of endometriosis in 11,000 women with celiac disease. <em>Hum Reprod.<\/em> 2011 Oct;26(10):2896-901. doi: 10.1093\/humrep\/der263.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_4_798\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_35_798\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_5_798\" class=\"footnote\">Santoro L, Campo S, D&#8217;Onofrio F, Gallo A, Covino M, Campo V, Palombini G, Santoliquido A, Gasbarrini G, Montalto M. Looking for celiac disease in Italian women with endometriosis: a case control study. <em>Biomed Res Int.<\/em> 2014;2014:236821. doi: 10.1155\/2014\/236821.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_5_798\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_6_798\" class=\"footnote\">Caserta D, Matteucci E, Ralli E, Bordi G, Moscarini M. Celiac disease and endometriosis: an insidious and worrisome association hard to diagnose: a case report. <em>Clin Exp Obstet Gynecol.<\/em> 2014;41(3):346-8.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_6_798\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_41_798\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_7_798\" class=\"footnote\">Sher KS, Mayberry JF. Female fertility, obstetric and gynaecological history in coeliac disease: a case control study. <em>Acta Paediatrica. Supplementum.<\/em> May 1996;412:76-7.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_7_798\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_8_798\" class=\"footnote\">Singh P, Arora S, Lal S, Strand TA, Makharia GK. Celiac Disease in Women With Infertility: A Meta-Analysis. <em>J Clin Gastroenterol<\/em>. 2015 Jan 1.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_8_798\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_31_798\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_9_798\" class=\"footnote\">Santoro L, Campo S, D&#8217;Onofrio F, Gallo A, Covino M, Campo V, Palombini G, Santoliquido A, Gasbarrini G, Montalto M. Looking for celiac disease in Italian women with endometriosis: a case control study.<em> Biomed Res Int<\/em>. 2014;2014:236821. doi: 10.1155\/2014\/236821.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_9_798\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_33_798\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_10_798\" class=\"footnote\">Collin P, Vilska S, Heinonen PK, Hallstrom O, Pikkarainen P. Infertility and coeliac disease. <em>Gut.<\/em> Sep 1996;39(3):382-4.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_10_798\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_11_798\" class=\"footnote\">Vancikova Z, Chlumecky V, Sokol D, et al. The serologic screening for celiac disease in the general population (blood donors) and in some high-risk groups of adults (patients with autoimmune diseases, osteoporosis and infertility) in the Czech republic. <em>Folia Microbiologica<\/em>. 2002;47(6):753-8.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_11_798\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_36_798\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_12_798\" class=\"footnote\">Meloni GF, Dessole S, Vargiu N, Tomasi PA, Musumeci S. The prevalence of celiac disease in infertility. <em>Human Reproduction<\/em>. Nov 1999;14(11):2759-61.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_12_798\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_38_798\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_13_798\" class=\"footnote\">Cosnes J, Cosnes C, Cosnes A, et al. Undiagnosed celiac disease in childhood. <em>Gastroenterologie Clinique et Biologique<\/em>. Jun-Jul 2002;26(6-7)616-23.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_13_798\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_37_798\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_14_798\" class=\"footnote\">Shamaly H, Mahameed A, Sharony A, Shamir R. Infertility and celiac disease: do we need more than one serological marker?\u00a0<em>Acta Obstetricia et Gynecologica Scandinavica<\/em>. Dec 2004;83(12)1184-8.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_14_798\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_15_798\" class=\"footnote\">Cosnes J, Cosnes C, Cosnes A, et al. Undiagnosed celiac disease in childhood. <em>Gastroenterologie Clinique et Biologique.<\/em> Jun-Jul 2002;26(6-7)616-23.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_15_798\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_16_798\" class=\"footnote\">Sher KS, Jayanthi V, Probert CS, Stewart CR, Mayberry JF. Infertility, obstetric and gynaecological problems in coeliac sprue. <em>Digestive Diseases<\/em>. May-Jun 1994;12(3):186-90.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_17_798\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_20_798\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_17_798\" class=\"footnote\">Jameson S. Zinc status in pregnancy: the effect of zinc therapy on perinatal mortality, prematurity, and placental ablation.\u00a0<em>Annals of the New York Academy of Sciences<\/em>. Mar 15, 1993;678:178-92.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_18_798\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_18_798\" class=\"footnote\">Wierdsma NJ, van Bokhorst-de van der Schueren MA, Berkenpas M, Mulder CJ, van Bodegraven AA. Vitamin and mineral deficiencies are highly prevalent in newly diagnosed celiac disease patients. <em>Nutrients<\/em>. 2013 Sep 30;5(10):3975-92. doi: 10.3390\/nu5103975.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_19_798\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_34_798\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_19_798\" class=\"footnote\">Tersigni C, Castellani R, de Waure C, Fattorossi A, De Spirito M, Gasbarrini A, Scambia G, Di Simone N. Celiac disease and reproductive disorders: meta-analysis of epidemiologic associations and potential pathogenic mechanisms. <em>Hum Reprod Update<\/em>. 2014 Jul-Aug;20(4):582-93. doi: 10.1093\/humupd\/dmu007.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_21_798\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_32_798\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_20_798\" class=\"footnote\">Cummins AG, Thompson FM, Butler RN, et al. Improvement in intestinal permeability precedes morphometric recovery of the small intestine in coeliac disease.\u00a0<em>Clinical Science<\/em>. Apr 2001;100(4):379-86.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_22_798\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_21_798\" class=\"footnote\">Farhadi A, Banan A, Fields J, Keshavarzian A. Intestinal barrier: an interface between health and disease.\u00a0<em>Journal of Gastroenterology and Hepatology<\/em>. 2003;18:479-91.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_23_798\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_24_798\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_25_798\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_26_798\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_27_798\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_28_798\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_22_798\" class=\"footnote\">https:\/\/umm.edu\/health\/medical\/altmed\/depletion\/antibiotic-medications-penicillin-derivatives.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_29_798\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_23_798\" class=\"footnote\">http:\/\/umm.edu\/health\/medical\/altmed\/depletion\/antibiotic-medications-macrolides<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_30_798\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_24_798\" class=\"footnote\">Sher KS, Mayberry JF. Female fertility, obstetric and gynaecological history in coeliac disease: a case control study. <em>Acta Paediatrica. Supplementum<\/em>. May 1996;412:76-7.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_39_798\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_25_798\" class=\"footnote\">Collin P, Vilska S, Heinonen PK, Hallstrom O, Pikkarainen P. Infertility and coeliac disease. <em>Gut<\/em>. Sep 1996;39(3):382-4.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_40_798\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><\/ol>","protected":false},"excerpt":{"rendered":"<p>What Is Infertility In\u00a0Females? Infertility in females is characterized by failure to conceive after one year of intercourse. This condition can be frustrating and emotionally upsetting to the parents trying to conceive. What Is Infertility In\u00a0Females In Celiac Disease and\/or Gluten Sensitivity?<\/p>\n","protected":false},"author":29,"featured_media":7297,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"categories":[4,779,102,783,105,108,117,24,167,222,974,221,111,109],"tags":[101,1901,116,1503,586,1904,776,619,1906,1912,1941,1974,57,100,1973,1908,1907],"class_list":["post-798","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-health-conditions-2","category-associated-disorder","category-calcium","category-complications-health-conditions-2","category-folic-acid","category-iron","category-magnesium","category-nutrient-deficiency-symptoms","category-omega-6-fatty-acids","category-ovaries","category-symptoms","category-female","category-vitamin-d","category-zinc","tag-associated-disorders","tag-calcium","tag-complications","tag-endometriosis","tag-female-infertility","tag-folic-acid","tag-health-conditions","tag-inflammation","tag-iron","tag-magnesium","tag-omega-6-fatty-acids","tag-ovaries","tag-reproductive-2","tag-symptom","tag-female","tag-vitamin-d","tag-zinc"],"_links":{"self":[{"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/posts\/798","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/users\/29"}],"replies":[{"embeddable":true,"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/comments?post=798"}],"version-history":[{"count":33,"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/posts\/798\/revisions"}],"predecessor-version":[{"id":18784,"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/posts\/798\/revisions\/18784"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/media\/7297"}],"wp:attachment":[{"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/media?parent=798"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/categories?post=798"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/tags?post=798"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}