DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20196008

A clinical study of association of genital tuberculosis with infertility in a tertiary centre of Jharkhand, India

Samarina Kamal, Vandita Singh, Shashibala Singh

Abstract


Background: The worldwide incidence of GTB is approximately 5- 10% in infertile women. It varies from as low as 0.69% in some developed countries to as high as 19% in India. It is diagnosed by culture of the tubercle bacillus from tissue sampled from the genital tract is the yardstick for diagnosis and remains the gold standard.

Methods: A prospective study was carried out between January 2012 and January 2015 on 100 women presenting with infertility.

Results: A total (27%) women were diagnosed as genital tuberculosis by combination of hystero laparoscopic findings, histopathological and endometrial DNA-PCR technique confirmation. Of these (40.62%) had secondary infertility and remaining (59.38%) had primary infertility. (15.62%) were previously diagnosed with pulmonary or extra pulmonary tuberculosis and had completed a full course of Anti-tubercular treatment as per WHO CAT 1 regime.

Conclusions: Therefore, in countries where TB is endemic, early and aggressive strategies should be pursued to diagnose and treat TB.


Keywords


Genital tuberculosis, Granuloma, Hysterolaparoscopy, Infertility, Paucibacillary, Polymerase chain reaction, Tubercles

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References


Muir DG, Belsey MA. Pelvic inflammatory disease and its consequences in the developing world. Am J Obstet Gynecol. 1980;138:913-28.

Schaefer G. Female genital tuberculosis. Clin Obstet Gynecol. 1976;19:223-39.

Aka N, Vural TZE. Evaluation of patients of active pulmonary tuberculosis for genital involvement. J Obstet Gynecol Res. 1997;23:337-40.

Varma TR. Genital tuberculosis and subsequent fertility. Int J Gynecol Obstet. 1991;35:1-11.

Novak and Woodruff. Novak’s gynecological and obstetrical pathology, 6th Edition; 2007:1988.

Arora R, Rathore A. Female genital tract tuberculosis. In: Arora VK, Arora R.(eds) Practical Approach to Tuberculosis Management, 1st edition. Delhi: Jaypee; 2006:113-119.

Bose M. Female genital tract tuberculosis: How long will it elude diagnosis? Indian J Med Res. 2011;134(1):13-4.

Bazaz Malik G, Maheshwari B, Lal N. Tuberculous endometritis: a clinicopathological study of 1000 cases. Br J Obstet Gynecol. 1983;90:84.

Bhanu NV, Singh UB, Chakraborty M. Improved diagnostic value of PCR in diagnosis of female genital tuberculosis leading to infertility. J Med Microbiol. 2005;54:927-31.

Jassawalla MJ. Genital tuberculosis: a diagnostic dilemma. J Obstet Gynecol India. 2006;56:203-4.

Jindal UN. An algorithmic approach to female genital tuberculosis causing infertility. Int J Tuber Lung Dis. 2006;10:1045-50.

Arora R, Rajaram P, Oumachigui A, Arora VK. Prospective analysis of short course chemotherapy in female genital tuberculosis. Int J Obstet Gynecol. 1992;38:311-4.

Rozati R, Roopa S, Rajeshwari CN. Evaluation of women with infertility and genital tuberculosis. J Obstet Gynecol India. 2006;56:423-6.

Gupta N, Sharma JB, Mittal s, Singh S, Mishra R, Kukreja M. Genital tuberculosis in infertility patients. Int J Gynecol Obstet. 2007;97:135-8.

Kulshrestha V, Kriplani A, Agarwal N, Singh UB, Rana T. Genital tuberculosis among infertile women and fertility outcome after antitubercular therapy. Int J Gynecol Obstet. 2011;113(3):229-34.

Schaefer G. Female genital tuberculosis. Clin Obstet Gynecol. 1976;19:223-39.

Bapna N, Mohanlal S, Namita K. Genital tuberculosis and its consequences on subsequent fertility. J Obstet Gynecol India. 2005;55(6):534-7.

Sin SY. Female genital tuberculosis. An update. Hong Kong Practioner. 1995;17(1):18-25.

Tripathy SN. Infertility and pregnancy outcome in female genital tuberculosis. Int J Gynaecol Obstet. 2002;76:159-63.

Puri S, Bhavana B. Diagnostic value of PCR in female genital TB and its therapeutic implications. J Obstet Gynecol India. 2009;59(1):67-70.