What role does HLA-DQ2 play in fertility?

HLA-DQ2 is a key genetic risk marker for celiac disease. Untreated celiac disease can impair fertility in both women and men due to malabsorption of critical nutrients (iron, folate, zinc) and autoimmune inflammation. However, carrying HLA-DQ2 alone does not predict disease or fertility problems – many carriers never develop celiac. The evidence linking HLA-DQ2 directly to fertility is indirect, based on observational studies of celiac populations. Consumer DNA tests only indicate risk, not diagnosis. For individuals with unexplained infertility and celiac symptoms, serological testing (tTG-IgA) is recommended. The role of HLA-DQ2 in fertility is thus mediated through celiac disease, not a direct genetic effect.