BACKGROUND<\/p>\n
The endometrial tuberculosis (TB) PCR test is now commonly employed for the diagnosis of female genital TB, a common cause of infertility in India. Although treatment in the absence of demonstrable tubal damage may be of doubtful benefit to fertility, the presence of mycobacterial DNA demonstrated by a positive PCR indicates infection by tubercle bacilli causing sub-clinical or latent disease potentially responsible for future clinical manifestations. This study was undertaken to assess the outcome of infertility management following early anti-tubercular treatment (ATT) based only on a positive endometrial TB-PCR test.<\/p>\n
METHODS<\/p>\n
This was an intervention study conducted at an IVF center in northern India in 443 infertile women of whom 169 (38.15%) were found to have positive TB-PCR (Group I), while 274 (61.85%) had negative Mycobacterium tuberculosis<\/I> (MTB)-PCR (Group II). Infertile women of <40 years of age, without any evidence of tubo-peritoneal or endometrial involvement, who underwent endometrial biopsy for the detection of MTB by PCR, were included. All the TB-PCR positive women were administered standard 6-month anti-tubercular chemotherapy. Additional treatment with assisted reproduction techniques was offered in the case of failure of spontaneous pregnancy after completion of ATT.<\/p>\n
RESULTS<\/p>\n
There were no statistical differences in the two groups in the overall pregnancy rate, 101 (59.8%) versus 167 (60.9%). In Group I, 48 (92.3%) spontaneous conceptions occurred within the first 12 months, i.e. during the period of ATT administration or within 6 months of treatment completion; in Group II, the occurrence of spontaneous conceptions was distributed more evenly in relation to time, i.e. 36 (53.7%) in <12 months as compared with 31 (46.3%) after first year (P<\/I>< 0.001).<\/p>\n
CONCLUSION<\/p>\n
Infertile women without tubal or endometrial damage given early anti-tuberculosis treatment based on a positive endometrial TB-PCR test had an excellent chance of early spontaneous conception.<\/p>\n
Source: BACKGROUND The endometrial tuberculosis (TB) PCR test is now commonly employed for the diagnosis of female genital TB, a common cause of infertility in India. Although treatment in the absence of demonstrable tubal damage may be of doubtful benefit to … Continue reading
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