Genital tuberculosis role in female infertility in Portugal

Reis‐de‐Carvalho, Catarina; Monteiro, J F; Calhaz‐Jorge, Carlos

doi:10.1007/s00404-020-05956-x

Cited by 6 publications

(7 citation statements)

References 15 publications

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“…The prevalence of FGTB in infertility patients varies from country to country being only 0.72% in Portugal, 1% in USA and Europe to 20% in Pakistan and 6–25% in India being more in tertiary referral centers and in assisted reproduction centers [ 16 – 20 ]. It also causes significant infertility in other south East Asian countries like Indonesia [ 21 ] FGTB is observed in younger age group (20–40 years) in South East Asia and Africa as compared to older (pre-menopausal) age group in Europe and USA possibly due to early child bearing in the developing countries [ 2 , 5 , 6 , 10 ]. Genital tuberculosis has significantly impacted both male and female reproduction in India [ 22 , 23 ].…”

Section: Epidemiologymentioning

confidence: 99%

“…It causes significant morbidity, especially irregular menstruation, pelvic pain, tubo-ovarian mass and infertility particularly in South East Asia and Africa [ 4 – 9 ]. The disease is making a comeback even in the developed countries like Europe and USA due to more liberal migration, concomitant immunocompromising diseases like human immunodeficiency virus coinfection, diabetes mellitus, chronic kidney and other systemic diseases [ 8 – 10 ]. FGTB is usually secondary to pulmonary TB through hematogenous route or lymphatic route but can occur through contagious spread from adjacent ileocaecal TB and rarely through infected semen from tuberculous orchitis in males [ 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

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Recent Advances in Diagnosis and Management of Female Genital Tuberculosis

Sharma

et al. 2021

J Obstet Gynecol India

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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.

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Section: Epidemiologymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Recent Advances in Diagnosis and Management of Female Genital Tuberculosis

Sharma

et al. 2021

J Obstet Gynecol India

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“…TA B L E 1 Symptoms and signs in female genital tuberculosis (FGTB) 5,8,22,49,55,73,74 Symptoms Signs…”

Section: Clinical Featuresmentioning

confidence: 99%

“…Female genital tuberculosis (FGTB) is an important subtype of extra pulmonary TB (EPTB) with significant impact on women's reproductive lives in the form of menstrual irregularities mainly oligomenorrhea, pelvic pain, tubo‐ovarian masses and in particular infertility especially in developing nations 5–7 . There have been reports of come back of the disease even in developed nations including USA and Europe due to more liberal immigration, HIV coinfection, diabetes, smoking, and other chronic diseases 8 . If left untreated, it can cause permanent damage to genital tract with poor prognosis for fertility 5–7 .…”

Section: Introductionmentioning

confidence: 99%

“…[5][6][7] There have been reports of come back of the disease even in developed nations including USA and Europe due to more liberal immigration, HIV coinfection, diabetes, smoking, and other chronic diseases. 8 If left untreated, it can cause permanent damage to genital tract with poor prognosis for fertility. [5][6][7] Hence early diagnosis and timely adequate treatment can prevent sequeale of TB with successful pregnancy outcome.…”

mentioning

confidence: 99%

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Immune disturbances in female genital tuberculosis and latent genital tuberculosis

Sharma

Sharma³

et al. 2022

American J Rep Immunol

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Background Female genital tuberculosis (FGTB), an important clinical sub‐type of extra‐pulmonary tuberculosis (EPTB) is responsible for about 10% cases of infertility in India. Both FGTB and latent genital tuberculosis (LGTB) can cause infertility through blockage of fallopian tubes and through altered uterine endometrial receptivity. Aims This review tries to elucidates the role of various immune factors in FGTB and LGTB. Content Various immune disturbances are observed in FGTB and LGTB like growth factors and cytokines which inhibit implantation and several inflammatory signaling pathways like mitogen activated protein kinase (MAPK), natural killer (NK) cells, nuclear factor kappa‐B (NF‐KB), tumor necrosis factor (TNF), and toll like receptors (TLR) signaling are dysregulated. These altered immune factors and pathways may be detected in the endometrial biopsies at the early stages of disease before permanent damage. Prompt and adequate treatment with the four anti‐tubercular drugs (rifampicin [R], isoniazid [H], pyrazinamide [Z], and ethambutol [E]) can increase pregnancy rates in some of these women. Assisted reproduction especially in‐vitro fertilization and embryo transfer may be required for some women. Implications Inflammatory pathways identified from the gene profiling have enabled development of potential biomarkers for early diagnosis of FGTB. Immunomodulation and novel biotechniques like stem cell transplantation, nanoparticles and host directed therapies are being tried in selected patients of FGTB and LGTB with promising results.

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Abdominopelvic tuberculosis in a nonsexually active young woman

Boitor-Borza

Mureşan

2023

American Journal of Obstetrics and Gynecology

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Genital tuberculosis role in female infertility in Portugal

Cited by 6 publications

References 15 publications

Recent Advances in Diagnosis and Management of Female Genital Tuberculosis

Recent Advances in Diagnosis and Management of Female Genital Tuberculosis

Immune disturbances in female genital tuberculosis and latent genital tuberculosis

Abdominopelvic tuberculosis in a nonsexually active young woman

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