Malnutrition and its derived symptoms most commonly present in undiagnosed females with celiac disease. This symptom can directly compromise the potential and ability to conceive due to a negative energy balance and the decreased ability to maintain fat storage in afflicted females. Those with undiagnosed celiac disease and who do not follow a gluten-free diet may intensify unfavorable conditions for conception within the body and, more specifically, within the reproductive system.
Due to celiac disease, women have deficiency of folic acid, iron, zinc and selenium, which is neccassary for a healthy reproductive life. All of them are essential for hormone production, and with lower levels of hormones, the ability of ovulation is decreased. Without ovulation, it is not possible to concieve a child.
Also women with celiac disease may start their periiods later and have earlier menopause, which leads to shorter period of fertility.
Men also suffer from infertility stemming from undiagnosed celiac disease. Affected males show a phenomenon of tissue resistance (insensitivity) to androgens (especially testosterone), which are neccessary for sperm development. The increased levels of follicle-stimulating hormone (FSH) and prolactin, which control the levels of androgens and thus also the sperm production, may indicate an imbalance at hypothalamus-pituitary (the highest regulatory centers of endocrine functions) level. Hypogonadism (diminished functional activity of the gonads—the testes in males) is a known factor in male infertility and has been found in 7% of celiac males in one survey.