Female genital tuberculosis: a global review.

Female genital tuberculosis is a symptomless disease inadvertently uncovered during investigation for infertility. The condition is relatively rare and often arises secondary to a primary focus elsewhere. The fallopian tube is the organ most commonly affected. Symptomatic disease usually presents with infertility, pelvic pain or menstrual irregularities. Diagnosis is daunting, even where grounds for suspicion exist. Molecular-based diagnostic methods are likely to play a prominent role in the future. Drug treatment is similar to that of pulmonary tuberculosis, although criteria for assessing the effectiveness of therapy are lacking. Return to fertility after treatment is not encouraging. In-vitro fertilization with embryo transfer remains the most effective method of treating associated infertility. Clinicians need to be aware of the existence of this important cause of infertility in women, in view of the continuing HIV epidemic and the current upsurge in tuberculosis worldwide, as well as the continuing migration of large numbers of women and their families out of areas where tuberculosis is endemic.