PROBLEM Which is the prevalence and seroprevalence of celiac disease (CD) in women with recurrent reproductive failure? METHOD OF STUDY Retrospective study performed in a single infertility clinic from September 2016 to December 2017. A total of 690 women with unexplained history of recurrent miscarriage and/or recurrent implantation failure were consecutively recruited. IgA anti-transglutaminase 2 (TG2) antibody data were collected, as well as IgG anti-TG2 and IgA/IgG anti-deamidated gluten peptide (DGP) data in most cases, and IgG anti-gliadin antibodies occasionally. In selected women, HLA-DQ genotyping was requested. Biopsy was suggested to all women with positive serological results or belonging to CD risk groups. Reproductive outcomes were recorded from women with high suspicion of CD and a control group comprised of 49 women. RESULTS Anti-TG2-positive women comprised 1% of the sample. An additional 4% was observed considering less-specific antibodies (31 women). Only 39% of sero-positive women accepted duodenal biopsy. HLA and biopsy data discarded CD in 14 sero-positive cases (37%), only one with anti-TG2 antibodies. CD was suggested in 10 sero-positive and three sero-negative women (1.9%). Compared with controls, the live birthrate of the studied women with probable CD was significantly decreased before gluten removal of the diet (P = .015), but significantly increased after that (P = .020). CONCLUSION One percent CD prevalence should be expected after anti-TG2 serological screening. However, more sensitive approaches should be explored, especially considering the potential beneficial effect of the gluten-free diet on the reproductive outcomes of women with CD.

中文翻译：

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探索患有复发性生殖衰竭的妇女的未经诊断的乳糜泻：无麸质饮食可以改善生殖结局。

问题复发性生殖衰竭妇女的乳糜泻（CD）患病率和血清流行率是什么？研究方法回顾性研究于2016年9月至2017年12月在单个不育诊所进行。连续招募了690名具有无法解释的反复流产和/或反复植入失败史的女性。在大多数情况下，会收集IgA抗转谷氨酰胺酶2（TG2）抗体数据，以及IgG抗TG2和IgA / IgG抗脱酰胺的谷蛋白肽（DGP）数据，偶尔还会收集IgG抗麦胶蛋白抗体。在选定的妇女中，要求进行HLA-DQ基因分型。建议所有血清学检查结果阳性或属于CD高危人群的妇女进行活检。高度怀疑CD的女性和49名女性组成的对照组记录了生殖结果。结果抗TG2阳性的女性占样本的1％。考虑到特异性较低的抗体（31名女性），另外观察到4％。血清阳性女性中只有39％接受十二指肠活检。HLA和活检数据在14例血清阳性病例（37％）中丢弃了CD，只有1例具有抗TG2抗体。建议在10例血清阳性和3例血清阴性的女性（1.9％）中使用CD。与对照组相比，研究对象的可能患有CD的妇女的活产率在去除麸质之前显着降低（P = .015），但此后显着提高（P = .020）。结论抗TG2血清学筛查后，CD患病率应为百分之一。但是，应该探索更敏感的方法，特别是考虑到无麸质饮食对患有CD的女性生殖结果的潜在有益作用。