Fertility Science and Research

REVIEW ARTICLE
Year
: 2016  |  Volume : 3  |  Issue : 1  |  Page : 6--18

Genital tuberculosis and infertility


Jai B Sharma, Sona Dharmendra, Shefali Agarwal, Eshani Sharma 
 Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India

Correspondence Address:
Jai B Sharma
Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029
India

Female genital tuberculosis (TB) is an important cause of significant morbidity, short- and long-term sequelae especially in infertility in which incidence varies from 5 to 15% cases in India. The causative agent is Mycobacterium tuberculosis. The fallopian tubes are mainly involved in 90 to 100% cases, endometrium in 60 to 80% cases, ovaries in 30% cases, and cervix in 15% cases of genital TB. Vagina and vulva TB is rare involving 1 to 2% cases. Diagnosis is made by detection of acid fast bacilli on microscopy or culture on endometrial biopsy or on histopathological detection of epithelioid granuloma on biopsy. Polymerase chain reaction (PCR) may be false positive and alone is not sufficient to make the diagnosis. Laparoscopy and hysteroscopy is the gold standard for the diagnosis of the disease. Treatment is by giving daily therapy of rifampicin (R), isoniazid (H), pyrazinamide (Z), and ethambutol (E) for 2 months followed by rifampicin (R) and isoniazid (H) daily for 4 months. Three weekly dosing throughout therapy (RHZE thrice weekly for 2 months followed by RH thrice weekly for 4 months) can be given as Directly Observed Treatment Short Course. Surgery is rarely required only for drainage of abscesses. Role of in vitro fertilization and embryo transfer is required in women whose fallopian tubes are damaged but endometrium is healthy. Surrogacy or adoption is needed for women whose endometrium is damaged.


How to cite this article:
Sharma JB, Dharmendra S, Agarwal S, Sharma E. Genital tuberculosis and infertility.Fertil Sci Res 2016;3:6-18


How to cite this URL:
Sharma JB, Dharmendra S, Agarwal S, Sharma E. Genital tuberculosis and infertility. Fertil Sci Res [serial online] 2016 [cited 2018 Aug 15 ];3:6-18
Available from: http://www.fertilityscienceresearch.org/article.asp?issn=2394-4285;year=2016;volume=3;issue=1;spage=6;epage=18;aulast=Sharma;type=0