Evidence check: Zöliakie Test in the context of Fruchtbarkeit

A celiac genetic test (HLA-DQ2/DQ8) can indicate an increased risk for celiac disease, but it is not a standalone diagnostic test. Untreated celiac disease is associated with fertility issues due to chronic inflammation and nutrient malabsorption (iron, folate, vitamin D). However, the genetic test alone does not confirm active disease; serology (tTG-IgA) and duodenal biopsy are required. Many individuals with risk genotypes never develop celiac. In the fertility context, the test is only a preliminary clue, not a basis for clinical decisions. The evidence for direct benefit of genetic testing in unexplained infertility is mixed. Recommendation: If celiac is suspected (e.g., gastrointestinal symptoms, unexplained iron deficiency), pursue standard diagnostic workup. A DNA test alone is insufficient. Safety note: Do not start a gluten-free diet without confirmed diagnosis, as it can mask symptoms and delay proper testing.