An algorithmic approach to female genital tuberculosis causing infertility.

SETTING

A private infertility care and in vitro fertilisation (IVF) centre in Northern India.

OBJECTIVES

To describe the prevalence, clinical spectrum, management strategy and outcome of infertility due to female genital tuberculosis (GTB) diagnosed with the help of a simplified tuberculosis (TB) algorithm.

DESIGN

Data from 150 women with infertility (Group I) and 47 women with general gynaecological problems (Group II) were analysed.

RESULTS

GTB was diagnosed in 7.2% of Group I and 2.8% of Group II women. Anti-tuberculosis treatment resulted in resolution of symptoms other than infertility in over 90% of cases. Of the total 20 pregnancies in the group, 10 were obtained in 32 IVF treatment patients.

CONCLUSIONS

A definitive bacteriological diagnosis was generally difficult to achieve in GTB before administration of anti-tuberculosis treatment. A high index of suspicion and several other morphological and/or laboratory criteria were employed. It is suggested that a step-wise algorithm can help in the management of these cases.