Is there any association between CVID or Selective IgA deficiency and infertility?


Thank you for your recent inquiry.

When one looks up the causes of infertility, neither common variable immunodeficiency nor IgA deficiency are noted. However, there is at least one review that has noted a relationship between IgA deficiency and infertility (see Gleicher below - I have copied a link to this article; it is available online free of charge).

In addition, IgA deficiency via its association with celiac disease has also been linked indirectly to infertility (see abstracts copied below).

However, I am unaware of any link between common variable immunodeficiency per se and infertility. This is perhaps not unexpected because common variable deficiency, as you know, is a very heterogenous diagnosis with many different defects underlying its mechanism(s) of production.

However, because of the general ill effect that common variable immunodeficiency has on the health of the patient, it would not be unexpected that infertility might occur secondarily.

Thank you again for your inquiry and we hope this response is helpful to you.

Norbert Gleicher: Human Reproduction Update 1998, Vol. 4, No. 2 pp. 169–176 (see page 171-173) - http://www.centerforhumanreprod.com/pdf/autoantibodies_infertility.pdf

Acta Obstet Gynecol Scand. 2004 Dec;83(12):1184-8.
Infertility and celiac disease: do we need more than one serological marker?
Shamaly H, Mahameed A, Sharony A, Shamir R.
Pediatric Gastroenterology and Nutrition Service, Department of Pediatrics, French Hopsital, Nazareth, Israel.
Objectives: Celiac disease (CD) prevalence is higher in women with infertility. Our study aims were to evaluate the prevalence of undiagnosed CD in Arab infertile women and to explore the usefulness of using more than one serological marker in the diagnostic screening for CD in this population.
Methods: Women with unexplained infertility (n = 192) and age-matched healthy controls (n = 210) were prospectively enrolled. Serum was tested for human tissue transglutaminase antibodies (TTG), antiendomysial antibodies (EMA), and immunoglobulin A. Intestinal biopsy was offered to women with positive serology or immunoglobulin A (IgA) deficiency.
Results: CD was diagnosed in five infertile women (2.65%) and in one control (0.5%) (p = 0.11). Gastrointestinal complaints were present in 60% (three of five) of women with CD and 11.8% (22 of 187) of women without CD (p = 0.017). Anemia was reported in 80% of infertile women with CD and 4.8% of infertile women without CD (p = 0.0001).
Conclusions: Undiagnosed CD is prevalent in Arab infertile women as well as in Arab women in general. CD in Arab infertile women is frequently associated with gastrointestinal complaints and anemia. EMA testing is sufficient in suspected cases.

J Obstet Gynaecol Res. 2011 May 11. doi: 10.1111/j.1447-0756.2010.01518.x. [Epub ahead of print]
Fertility disorder associated with celiac disease in males and females: fact or fiction?
Khoshbaten M, Rostami Nejad M, Farzady L, Sharifi N, Hashemi SH, Rostami K.
Liver and Gastrointestinal Disease Research Center Department of Infertility, Alzahra University Hospital Health and Nutrition Faculty, Tabriz University of Medical Sciences Gastroenterologist and Hepatologist, Alinasab Hospital, Tabriz Research Center for Gastroenterology and Liver Diseases, Shaheed Beheshti University M.C., Tehran, Iran School of Medicine, University of Birmingham, Birmingham, UK.
The Aim: association between celiac disease and infertility is controversial in the literature. The aim of this study was to determine the prevalence of celiac disease among the couples with unexplained infertility. Material & Serum samples from 100 Iranian couples with
Methods: infertility were evaluated for celiac disease by unexplained tissue transglutaminase antibody (tTGA). Two hundred couples not reporting reproductive problems and having delivered at least one uncomplicated birth served as controls. Total immunoglobulin A (IgA) was also obtained to investigate IgA deficiency. Those with IgA deficiency were tested with IgG tTG. Those cases with positive tTGA or tTGG (IgA deficients) underwent upper gastrointestinal endoscopy. Positive
Results: results of tTGA were detected in 13 infertile subjects (6.5%, 6 females) and 11 controls (2.8%, 4 males = males and 7 0.027). The odds and 7 females) (P ratio of celiac disease in unexplained infertile couples was 2.39 (95% CI: 1.15-5.01) compared with fertile couples. IgA deficiency was identified in 14 infertile cases and 11 controls. Only 5/24 tTGA-positive and 4/24 IgA-deficient infertile subjects and controls accepted to undergo duodenal mucosal biopsy. Celiac disease was confirmed by biopsy in three (1.5%) of the unexplained infertile. The results of this study show that there is a higher patients.
Conclusion: seroprevalence of celiac disease in those with infertility in comparison to those with normal fertility.

Phil Lieberman, M.D.

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