How are tTG IgA and Fruchtbarkeit related?

tTG IgA (tissue transglutaminase antibody) is the primary serological marker for celiac disease. Elevated levels indicate active or untreated celiac disease. Strong human evidence links untreated celiac disease to fertility problems: in women, recurrent miscarriage, unexplained infertility, and delayed menarche; in men, impaired sperm quality and motility. Mechanisms include malabsorption of key nutrients (zinc, folate, iron) and systemic inflammation/autoimmunity. Importantly, the tTG IgA test does not directly measure fertility but screens for celiac disease. A positive result requires gastroenterological follow-up (including duodenal biopsy). A gluten-free diet often restores fertility in affected individuals. Evidence is strong (multiple meta-analyses and cohort studies). Caveat: a negative test does not fully rule out celiac disease, especially in IgA deficiency.