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.