Is tTG IgA useful for fertility?

The tTG IgA test (tissue transglutaminase antibody) is a well-established screening tool for celiac disease, an autoimmune condition triggered by gluten. Untreated celiac disease has been associated with fertility problems in both women and men – possible mechanisms include nutrient malabsorption (e.g., iron, zinc, folate), chronic inflammation, and hormonal disturbances. Some studies report improved fertility after adopting a gluten-free diet in affected individuals. However, tTG IgA is not a direct fertility test. The evidence for routine celiac screening in unexplained infertility is moderate: some guidelines recommend it, but universal screening is not standard. The test is most useful when celiac symptoms or risk factors are present. Without such indications, its value for fertility assessment is limited. Caveat: A negative tTG IgA does not completely rule out celiac disease (especially in IgA deficiency). Interpretation should always be done by a physician.