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Gluten intolerance could be possible cause of “unexplained infertility”

Fertility experts said up to 25 per cent of infertile patients are classified as having "unexplained infertility", and an expert said a possible explanation could be intolerance to gluten.

SINGAPORE: Fertility experts said up to 25 per cent of infertile patients are classified as having "unexplained infertility", and an expert said a possible explanation could be intolerance to gluten.

Colleen Francisca has always had a sweet tooth. The 32-year-old decided to start a dessert parlour in 2012.

But last year, she experienced a serious allergic reaction after eating a pastry, and was forced to re-think her love of desserts.

Ms Francisca said: "I couldn't breathe. My airway closed up on me and my face started to swell."

A series of tests diagnosed Ms Francisca as gluten-intolerant.

Symptoms of gluten intolerance include bloating, abdominal pain, diarrhoea or joint pain.

She immediately cut out foods processed from wheat from her diet, such as cakes.

A month later, Ms Francisca was shocked to learn that she was pregnant as she had been trying to conceive for the past six years.

She had also tried artificial insemination treatments.

Ms Francisca said: “We did a series of tests, some being the blood dye test, a blood test as well to see what my hormone levels were, and my husband of course did the sperm test, and the usual general tests, and we were fine.

"We were perfectly fertile, both of us, so it was very frustrating to hear from your doctor, ‘it's (infertility) unexplained". We've tried everything else and the only different thing I did was to give up gluten and change my diet.”

Doctors usually classify infertility cases as "unexplained" after they have examined a series of factors, including sperm count, ovulation cycles and blockages in the fallopian tubes.

If it is established that there are no problems with the factors, that is usually when the artificial insemination treatments begin.

A fertility expert has pointed to a higher incidence of gluten intolerance among patients with "unexplained infertility".

Dr Loh Seong Feei, senior consultant for obstetrics & gynecology at Thomson Fertility Centre, said: "In gluten intolerance, there is some degree of autoimmunity, as in the body produces antibodies against the intestine, and subsequently causes the intestine to have the problem of malabsorption, and it may be some auto immune condition which causes the infertility issue.

“Maybe it is time to look at the strategy to either screen for it or to treat this group of patients so that instead of relying on IVF (in vitro fertilisation) or artificial insemination, a simple change of the diet sometimes would suffice to help this group of patients conceive."

But not all fertility experts agree.

Dr Suresh Nair, senior obstetrician & gynaecologist for Gynecology Consultants Clinic & Surgery at Mt Elizabeth Medical Centre, said: "Honestly, we haven't got enough data to show a direct causal link. There might be an association. There are papers to say and claim causal link but if you really scrutinise there are a lot of deficiencies."

Doctors do agree though that more research needs to be done on the prevalence of gluten intolerance in Asia, before screening for the allergy is practiced at fertility clinics.

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