Unexplained fertility due...

A 26-year-old female patient presented to a gynecologist for infertility after trying to conceive for two years. She had a regular menstrual cycle with no history of medical problems, surgeries, or drug or alcohol abuse. Her husband had a normal male factor and spermogram. After performing primary and secondary evaluations, she was diagnosed with unexplained infertility and suggested to undergo IVF. Nine months ago, the patient had medical consultation due to diarrhoea and weight loss of 3 kgs, which lasted for a year and was characterized as non-bloody and osmotic. Her laboratory findings revealed iron deficiency anemia. Based on intestinal signs and 4 years of infertility, the patient was suspected of having celiac disease. This suspicion was confirmed by positive serological factors (total IgA and tTG) and biopsy findings, showing severe malabsorption and damage to the duodenal mucosa (Figure 1). The patient was diagnosed with celiac disease and started a gluten-free diet, successfully treating her diarrhoea, flatulence, and anemia. Three months later, she became pregnant.