Do Women with Coeliac Diseae Clinically Present with Fertility Problems more often than Women in the General Population
METHODS: Using a large primary care database of patients from across the UK, we estimated age-specific rates of new clinically recorded fertility problems in women with and without CD during their childbearing years between 1990 and 2013. These rates were stratified by whether the fertility problem was recorded before or after the CD diagnosis and were compared to the general population rates using Poisson regression with adjustments for socioeconomic status and calendar time.
RESULTS: Out of 2,426,225 women, 6,506 (0.3%) had a diagnosis of CD. The age specific-rates of new clinically recorded fertility problems in women with CD were very similar to the general population rates (11.6/1,000 person-years in women with CD and 12.6/1,000 person-years in the general population in the 30-34 year age group). When stratified by the time of CD diagnosis the rates of clinically recorded fertility problems were very similar to the general population in both the time before and after CD diagnosis. However these rates were 50% higher after CD diagnosis in women aged 25-29 compared to the same age group in the general population (IRR 1.50, 95% CI 1.10-2.04).
CONCLUSIONS: Women with CD do not have a substantially greater likelihood of reporting fertility problems than women without the condition. Rates were slightly higher in younger women with diagnosed CD, however as this effect did not hold for women of other age groups, increased ascertainment of the condition rather than a causal association may explain this.