Genital tuberculosis and infertility

Sharma, Jai Bhagwan; Dharmendra, Sona; Agarwal, Shefali; Sharma, Eshani

doi:10.4103/fsr.fsr_2_17

Cited by 28 publications

(63 citation statements)

References 2 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Interestingly, genital tract is almost never a primary infection site (1). Most frequent sites of involvement are the fallopian tubes (90-100%), endometrium (50-60%) and ovaries (30%) similar to present case (3,4,5). Involvement of cervix, vulva and vagina is less common (6).…”

Section: Discussionsupporting

confidence: 58%

“…Tubal function is lost due to the damage to cilia which can result in ectopic pregnancies as well. Perisalpingitis causes adhesions and leads to the formation of tubo-ovarian masses (2,4). If the endometrium is superficially affected, secretory response of the endometrium to hormones remains intact.…”

Section: Discussionmentioning

confidence: 99%

“…Severe involvement leads to ulcerative or fungating lesions and even obliteration of the uterine cavity with adhesions (Ashermans syndrome), grossly mimicking carcinoma (1). Endometrial atrophy can also occur with total destruction of the uterine cavity causing amenorrhoea and occlusion of cavity resulting in pyometron (1,4). Inflammation of the ovarian cortex induces the production of various cytokines and growth factors which adversely affect oocyte development along with the direct effect of mycobacterial toxins.…”

Section: Discussionmentioning

confidence: 99%

“…Inflammation of the ovarian cortex induces the production of various cytokines and growth factors which adversely affect oocyte development along with the direct effect of mycobacterial toxins. Ovarian reserve gets diminished and chronic anovulation occurs (2,4). In addition to that, mycobacteria can inhibit progesterone production and cause luteal phase defect and implantation failure with increased risk of miscarriage (4).…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, the embryo quality also tends to be low (4). Endometrial receptivity is reduced due to defective vascularization and activation of various factors and immunomodulation (2,4). Commonly used investigations in a patient suspected of GTB include chest X-ray, tuberculin test, hysterosalpingogram, laparoscopy with biopsy and endometrial curettage.…”

Section: Discussionmentioning

confidence: 99%

See 4 more Smart Citations

Genital tuberculosis in a Woman Manifested as Secondary Subfertility

Wickramaratne

Idirisinghe²,

Samaranayake³

2018

J Diagnostic Path

View full text Add to dashboard Cite

A 35-year-old mother of one child, presented with inability to conceive for two years and a chronic lower abdominal pain. Laparoscopy revealed extensive adhesions in the bilateral adnexal regions and adhesion of uterus to the bowel. Subsequently, she underwent a total abdominal hysterectomy and bilateral salpingo-oophorectomy.Histopathological examination of endometrium, myometrium, both ovaries and fallopian tubes revealed several granulomata with caseous necrosis. Special stain for acid fast bacilli was negative. However, based on the presence of characteristic caseating granulomata, the diagnosis is most likely tuberculosis.

show abstract

Section: Discussionsupporting

confidence: 58%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Genital tuberculosis in a Woman Manifested as Secondary Subfertility

Wickramaratne

Idirisinghe²,

Samaranayake³

2018

J Diagnostic Path

View full text Add to dashboard Cite

show abstract

Recent Advances in Diagnosis and Management of Female Genital Tuberculosis

Sharma

et al. 2021

J Obstet Gynecol India

Self Cite

View full text Add to dashboard Cite

Female genital tuberculosis (FGTB) is an important cause of significant morbidity and infertility. Gold-standard diagnosis by demonstration of acid fast bacilli on microscopy or culture or detection of epithelioid granuloma on histopathology of endometrial or peritoneal biopsy is positive in only small percentage of cases due to its paucibacillary nature. Use of gene Xpert on endometrial or peritoneal biopsy has improved sensitivity of diagnosis. Composite reference standard (CRS) is a significant landmark in its diagnosis in which combination of factors like AFB on microscopy or culture, positive gene Xpert, epithelioid granuloma on endometrial or peritoneal biopsy, demonstration of definite or probable findings of FGTB on laparoscopy or hysteroscopy. There have been many advances and changes in management of FGTB recently. The program is now called National Tuberculosis Elimination Program (NTEP), and categorization of TB has been stopped. Now, patients are divided into drug-sensitive FGTB for which rifampicin (R), isoniazid (H), pyrazinamide (Z) and ethambutol (E) are given orally daily for 2 months followed by three drugs (rifampicin, isoniazid and ethambutol (RHE) orally daily for next 4 months. Multi-drug-resistant FGTB is treated with shorter MDR TB regimen of 9–11 months or longer MDR TB regimen of 18–20 months with reserved drugs. In vitro fertilization and embryo transfer have good results for blocked tubes and receptive endometrium, while surrogacy or adoption is advised for severe grades of Asherman’s syndrome.

show abstract