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Genital tuberculosis among infertile women and fertility outcome after antitubercular therapy
Author(s) -
Kulshrestha Vidushi,
Kriplani Alka,
Agarwal Nutan,
Singh Urvashi B.,
Rana Tanu
Publication year - 2011
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2010.12.014
Subject(s) - medicine , laparoscopy , tuberculosis , hysterosalpingography , hysteroscopy , fertility , mycobacterium tuberculosis , gynecology , sex organ , obstetrics , surgery , infertility , population , pregnancy , pathology , environmental health , biology , genetics
Objective To compare modalities for diagnosing genital tuberculosis (GTB) and to assess fertility outcome after antitubercular therapy (ATT). Methods Infertile women underwent endometrial aspiration (EA) and peritoneal washing (PW) for histopathologic examination, PCR, and acid‐fast bacilli (AFB) smear and culture of Mycobacterium tuberculosis ; laparoscopy and hysteroscopy were also performed. Women with a positive laboratory test and/or laparoscopic finding classified as definitive/probable received ATT for 6 months. Results Of 196 women recruited, 187 underwent laparoscopy. Genital tuberculosis was diagnosed in 118 (60.2%). In 41.3%, EA PCR was positive; PW PCR was positive in 7.6%. The remaining laboratory tests were positive in a small number. Laparoscopy indicated definitive GTB in 9.1% and probable GTB in 37.4%. Among the 118 women treated for GTB, 22.9% conceived without in vitro fertilization; of these women, 74.1% had a positive EA PCR and 59.3% had a positive laparoscopy finding. A quarter of the women received ATT solely on the basis of the PCR result and 31.0% of these women conceived. Conclusion No single test can detect all instances of GTB. A combination of tests is needed to increase the detection rate. Treatment given solely on the basis of a positive PCR result can result in conception.