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.