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Testing & Diagnosis in Women

 

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If you suspect celiac disease in any of your patients, a simple and easy serology can test for the disorder. Currently, there are no guidelines for celiac disease testing in patients with infertility, despite evidence that this autoimmune disease exists in 4% to 8% of women with unexplained infertility 1, 2, 3.

It is well-known that it is best to catch celiac disease as early as possible since the diagnosis and treatment can significantly improve an individual’s overall well-being.

Furthermore, the screening of pregnant women in at-risk populations and areas of high prevalence has been found to be cost-effective due to the low cost of serological screening when compared to the significant medical expenses associated with adverse pregnancy outcomes 3, 4.

Blood tests are the first step in a diagnosis of celiac disease. Healthcare providers should order one or more of a series of blood tests to measure the body's response to gluten. Currently, recommended tests include:

  • Total IgA
  • IgA-tTG
  • IgA-EMA
  • If IgA is deficient, it is recommended that the IgG/IgA-DGP also be ordered. At the discretion of the doctor, IgG-AGA can also be ordered.

References:

1. Collin, P., Vilska, S., Heinonen, P.K., et al. (1996). Infertility and celiac disease. Gut, 39, 382-384.

2. Meloni, G.F., Dessole, S., Vargiu, N., et al. (1999). The prevalence of celiac disease in infertility. Human Reproduction, 14(11), 2759-2761.

3. Shah, S. & Leffler, D. (2010). Celiac disease: An underappreciated issue in women’s health. Journal of Women’s Health, 6(5), 1-14.

4. McCarthy, F.P., Khashan, A.S., Quigley, E., et al. (2009). Undiagnosed maternal celiac disease in pregnancy and an increased risk of fetal growth restriction. Journal of Clinical Gastroenterology, 43, 792-793.

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