Genital tuberculosis: a leading cause for infertility in women seeking assisted conception in North India.

INTRODUCTION

Genital tuberculosis is a major cause of tubal factor infertility in developing countries. Data regarding the current prevalence of tuberculosis in the infertile population are sparse.

AIMS: To determine the incidence of tubal factor infertility in an infertile population seeking assisted reproduction and the prevalence of genital tuberculosis in this sub-group of patients and their symptomatology.

MATERIALS AND

METHODS

A retrospective analysis of case records of infertile patients registered for in-vitro fertilization (IVF) between January 2007 and June 2007.

RESULTS

Hundred and forty women with an indication for IVF were analyzed. Of these, 70 patients (50%) had tubal factor infertility. The prevalence of genital tuberculosis in tubal factor infertility was 34 out of 70 (48.5%). 82.8% of patients with tubal factor had history of prior treatment for tuberculosis. Menstrual abnormalities were seen in only 8 patients: hypomenorrhea (7) and secondary amenorrhea (1). A diagnostic hysteroscopy showed that 11 had uterine adhesions (18.9%) and 1 patient had pale endometrium. Twenty patients out of 70 cases (28.5%) showed evidence of extra genital tuberculosis.

CONCLUSION

Genital tuberculosis is the major causative factor for severe tubal disease requiring assisted reproduction in developing countries like India.