Coeliac Disease and Fertility: Why Nutrition and Early Diagnosis Matter

When you are preparing for pregnancy, nutrition is more than fuel. It is the foundation for fertility. Iron, folate, vitamin D, calcium, zinc, and protein all play critical roles in ovulation, implantation, and foetal development. But if coeliac disease is undiagnosed, your body will struggle to absorb these nutrients, leaving fertility at risk.

Recent updates in international guidelines have sharpened how coeliac disease is diagnosed in adults. For women in their reproductive years, this means earlier clarity, fewer unnecessary procedures, and faster access to a safe gluten-free diet. And that is where nutrition steps in.

Coeliac disease is an autoimmune condition where gluten damages the lining of the small intestine. This damage reduces the absorption of key nutrients. For women trying to conceive, the consequences can be significant because:

• Low levels of iron can increase the risk of anaemia

• Low levels of folate can increase the risk of neural tube defects

• Vitamin D and calcium are essential for bone health and pregnancy outcomes

• Zinc supports hormone balance and egg quality

• Protein and B vitamins support energy, hormone production, and foetal growth

  
  

Without diagnosis, these deficiencies can persist silently. With diagnosis, a gluten-free diet restores absorption and allows nutrient stores to be rebuilt.

Once coeliac disease is confirmed, nutrition becomes the foundation of fertility preparation. A gluten-free diet isn’t just about removing gluten. It is about adding back abundance.

• Leafy greens, legumes, and fortified gluten free grains for folate and iron

• Dairy or fortified plant milks for calcium (vitamin D from the sun)

• Lean meats, eggs, nuts, and seeds for protein and zinc

• Gluten-free whole grains like quinoa, buckwheat, and amaranth for fibre and B vitamins

  
  

Beyond the basics, several other nutrients deserve attention in fertility planning with coeliac disease:

• Iodine which is essential for thyroid health and foetal brain development.

• Selenium to supports thyroid function and protects reproductive cells from everyday stress.

• Vitamin B12 which is important for red blood cell formation and neurological development.

• Magnesium aids muscle function, hormone regulation, and energy metabolism

• Fat-soluble vitamins (A, E, K) support reproductive health, antioxidant protection, and bone health.

• Omega-3 fatty acids regulate hormones, reduce inflammation, and support foetal brain development.

  
  

All these can be obtained from food.

Many women adopt a gluten-free diet before formal testing. While this can ease symptoms, it complicates diagnosis. If coeliac disease is suspected, a structured gluten challenge with the help of a dietitian and gastroenterologist may be needed to confirm the condition. This step is important before fertility planning, as it ensures nutrition strategies are safe, evidence-based, and tailored to pregnancy.

Not all gluten reactions are coeliac disease. Some women experience non-coeliac wheat sensitivity, where symptoms occur without intestinal damage. The nutrition approach differs for this. in some case the low FODMAP diet may be a suitable dietary intervention.

For fertility, ruling out coeliac disease first is essential, as untreated disease carries risks for pregnancy outcomes.

For women preparing for pregnancy, the message is clear. Early diagnosis of coeliac disease matters, and nutrition is the key to restoring fertility needs. By combining evidence-based diagnosis with personalised nutrition, women can move into fertility planning with confidence knowing their bodies are nourished, resilient, and ready for the journey ahead.

I leave you with a basic gluten free meal

Breakfast

Vegetable omelette with spinach, mushrooms, and cheese

1 slice gluten‑free toast with avocado

A small glass of of milk

Morning Snack

Greek yoghurt topped with chia seeds and berries

Lunch

Quinoa salad with roasted pumpkin, chickpeas, baby spinach, and sunflower seeds

Olive oil and lemon dressing and a side of boiled eggs

Afternoon Snack

A handful of mixed nuts and a kiwi fruit

Dinner

Grilled salmon, steamed broccoli and carrots with brown rice or buckwheat

 Evening Snack (optional)

Warm milk and a slice of gluten‑free banana bread made with almond meal

Every woman’s needs are unique. Working with an Accredited Practising Dietitian ensures your gluten‑free fertility plan is tailored for portion sizes, supplementation (if needed), and cultural food preferences, while remaining safe, and clinically sound.

Are you ready to take this journey with me.....