Impact of Latent Tuberculosis Infection on Ovarian Reserve and In Vitro Fertilization or Intracytoplasmic Sperm Injection Outcomes: A Retrospective Cohort Study with Propensity Score Matching.

Background: Tuberculosis is a communicable disease that is a major cause of ill health and one of the leading causes of death worldwide. Latent tuberculosis infection (LTBI) widely exists in people all over the world, especially in patients with unexplained infertility, and the relationship between latent tuberculosis infection and ovarian reserve, as well as pregnancy outcomes of in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI), remains poorly understood. Methods: A single-center, retrospective cohort study was conducted at the Reproductive Medicine and Genetics Centre, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, between January 2018 and December 2020. The study aimed to investigate whether LTBI affects ovarian reserve and pregnancy outcomes in infertile women undergoing assisted reproductive technology. The primary outcomes were ovarian reserve and cumulative live birth rate per IVF/ICSI cycle, while secondary outcomes included pregnancy outcomes and maternal and neonatal complications. Results: A total of 11523 assisted reproductive technology cycles were ultimately included in the comparison of ovarian reserves, and 9141 IVF/ICSI cycles were ultimately included in the comparison of clinical outcomes between the LTBI and control groups. The data revealed that women with LTBI had significantly lower anti-Müllerian hormone (4.61 ± 3.99 ng/mL vs. 4.88 ± 4.22 ng/mL, P=0.035, β=-0.23, 95% CI -0.43 to -0.04) and antral follicle counts [11.00 (8.00, 17.00) vs. 12.00 (8.00, 19.00), P=0.048, β=-0.26, 95% CI -0.53 to -0.01]. The conservative and optimistic cumulative live birth rates (61.42% vs. 61.94%, adjusted OR: 0.95, 95% CI: 0.82-1.10; 72.65% vs. 73.25%, adjusted OR: 0.94, 95% CI: 0.78-1.14), the live birth rates after fresh embryo transfer (39.28% vs. 40.83%, adjusted OR: 0.97, 95% CI: 0.82-1.14) and other secondary outcomes in the LTBI group were comparable to those in the control group after excluding factors such as age, ovarian reserve, and the number of oocytes retrieved. Conclusions: LTBI may affect the ovarian reserve but not directly affect the pregnancy outcomes of IVF/ICSI in infertile women.