Female Genital Tuberculosis and Subfertility: Nobel Approaches for Successful Reproductive Outcome with Anti Tubercular Drug Therapy in Bangladesh Perspective

Abstract

Background: Female Genital Tuberculosis is one of the important causes of infertility in Bangladesh. An early diagnosis and treatment with ATT (Anti Tubercular Therapy) is important to prevent adverse sequlae and can improve reproductive outcome. Aims and Objectives: The aim of the study is to evaluate the reproductive outcome of infertile patients with GTB. Methods: The present prospective observational study was conducted in Reproductive Endocrinology and Infertility Department of BSMMU from January 2018 to December 2021. Thirty (30) infertile women suspected of Genital Tuberculosis (GTB) who undergone hystero-laparoscopy as a part of infertility work up were included in our study. Results: GTB is the disease of young women with the mean age 27.5 ± 5.49 years in our study and most commonly present with primary infertility (63.33%). After completing antitubercular treatment, 90% of the study group had resumed normal menstrual cycles. A comparable proportion (16.67%) of GTB patients receiving ATT conceived, all without the aid of IVF. Among those who were conceived, 60% pregnancy remained uneventful, 20% had abortion, and 20% had ectopic pregnancy. The median length of time to conception after initiation of ATT was 4 months, stressing the role of ATT in conception in women with GTB. Conclusions: In low-income countries like Bangladesh where IVF is costly, Anti Tubercular Therapy may be started even on the basis of positive DNA PCR result or on the basis of laparoscopic and hysteroscopic findings. Effective anti- tubercular therapy can provide successful reproductive outcome in infertile patients with Genital TB.