Favorable infertility outcomes following anti-tubercular treatment prescribed on the sole basis of a positive polymerase chain reaction test for endometrial tuberculosis

Jindal, Umesh; Verma, S.; Bala, Yohann

doi:10.1093/humrep/des076

Cited by 64 publications

(58 citation statements)

References 20 publications

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“…The tests will depend upon the site of TB and its clinical presentation. The various tests are shown in Table 3 [29][30][31][32][33].…”

Section: Diagnosismentioning

confidence: 99%

“…Hence ATT should not be started just on the basis of positive PCR unless there is some other evidence of FGTB on clinical examination or on investigations like the presence of tubercles or other stigmata of TB on laparoscopy. However, Jindal et al [33] observed high pregnancy rate for treating infertility with positive PCR alone with ATT peritonitis (8 vs 1.8 %) [37]. The adhesions are typically vascular, and adhesiolysis can increase the risk of bleeding and flare-up of the disease [8,36,37].…”

Section: Adhesionsmentioning

confidence: 99%

See 1 more Smart Citation

Current Diagnosis and Management of Female Genital Tuberculosis

Sharma

2015

J Obstet Gynecol India

123

145

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Female genital tuberculosis (FGTB) is an important cause of significant morbidity, short-and longterm sequelae especially infertility whose incidence varies from 3 to 16 % cases in India. Mycobacterium tuberculosis is the etiological agent for tuberculosis. The fallopian tubes are involved in 90-100 % cases, endometrium is involved in 50-80 % cases, ovaries are involved in 20-30 % cases, and cervix is involved in 5-15 % cases of genital TB. Tuberculosis of vagina and vulva is rare (1-2 %). The diagnosis is made by detection of acid-fast bacilli on microscopy or culture on endometrial biopsy or on histopathological detection of epithelioid granuloma on biopsy. Polymerase chain reaction may be false positive and alone is not sufficient to make the diagnosis. Laparoscopy and hysteroscopy can diagnose genital tuberculosis by various findings. Treatment is by giving daily therapy of rifampicin (R), isoniazid (H), pyrazinamide (Z) and ethambutol (E) for 2 months followed by daily 4 month therapy of rifampicin (R) and isoniazid (H). Alternatively 2 months intensive phase of RHZE can be daily followed by alternate day combination phase (RH) of 4 months. Three weekly dosing throughout therapy (RHZE thrice weekly for 2 months followed by RH thrice weekly for 4 months) can be given as directly observed treatment short-course. Surgery is rarely required only as drainage of abscesses. There is a role of in vitro fertilization and embryo transfer in women whose fallopian tubes are damaged but endometrium is healthy. Surrogacy or adoption is needed for women whose endometrium is also damaged.

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“…The tests will depend upon the site of TB and its clinical presentation. The various tests are shown in Table 3 [29][30][31][32][33].…”

Section: Diagnosismentioning

confidence: 99%

Section: Adhesionsmentioning

confidence: 99%

Current Diagnosis and Management of Female Genital Tuberculosis

Sharma

2015

J Obstet Gynecol India

123

145

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“…[6][7][8][9] A recent study by Jindal et al also reported favorable infertility treatment outcome following anti-tubercular treatment, prescribed on basis of positive PCR. 10 We used the most widely used primers i.e. IS6110 to detect Mycobacterium tuberculosis by single tube nested PCR and it was positive in this case.…”

Section: Discussionmentioning

confidence: 88%

Utility of PCR in the Diagnosis of Female Genital Tuberculosis

Kaur¹

2014

Jmid

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Genital tuberculosis (GTB) is one of the major causes of infertility among females. Since the infection is asymptomatic in most of the cases, it makes the clinical diagnosis quite difficult. We report a case of a 24 years old female with infertility that was discovered to have endometrial tuberculosis, detected by PCR using IS6110. The culture report was negative and histopathological examination indecisive. She was given anti-TB therapy and subsequently had a pregnancy with a live birth. Although conventional methods like culture on Lowenstein-Jensen medium and histopathology are important in the diagnosis of such cases but the molecular methods like PCR can be a highly useful aid in the establishment of a rapid and early diagnosis of genital and other forms of extra-pulmonary tuberculosis. J Microbiol Infect Dis 2014;4(2): 72-74

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“…[23] V. N. Jindal, S. Verma and Y Bala in their study of 443 cases on fertility outcomes following anti-tubercular treatment showed overall pregnancy rate of 59.8%. [24] In our study treatment to all affected individual was given. Spontaneous pregnancies was achieved in 2 out of 9 women, after 6 months of anti-tubercular treatment.…”

Section: Discussionmentioning

confidence: 99%

Study of Genital Tuberculosis in Infertile Women

Ohri¹,

Patil²,

Patil³

et al. 2016

jemds

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AIMTo determine the incidence of female Genital Tuberculosis (GTB) and to analyse clinicopathological features for GTB and comparison of Polymerase Chain Reaction (PCR), Acid Fast Bacillus (AFB) staining and Histopathology (HPR). STUDY SETTINGA prospective study conducted on 50 infertile patients in the Department of Obstetrics and Gynaecology at Krishna Hospital, Karad, for a period of 2 years between December 2013 and December 2015. METHODSPatients were investigated for the presence of Mycobacterium Tuberculosis (MTB) on samples collected by endometrial curettage by PCR, AFB and HPR. Additional tests like Hysterosalpingography (HSG) Laparoscopic chromopertubation and hysteroscopy were performed if not done earlier. RESULTPCR demonstrated MTB DNA in 9 patients, and 2 were positive with AFB and HPR. Within positive patients HSG findings were suggestive of TB in 3 cases and laparoscopy in 5 cases and hysteroscopy in 4 cases. Two MTB PCR positive patients conceived spontaneously after 6 months of anti-tubercular treatment.

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Favorable infertility outcomes following anti-tubercular treatment prescribed on the sole basis of a positive polymerase chain reaction test for endometrial tuberculosis

Cited by 64 publications

References 20 publications

Current Diagnosis and Management of Female Genital Tuberculosis

Current Diagnosis and Management of Female Genital Tuberculosis

Utility of PCR in the Diagnosis of Female Genital Tuberculosis

Study of Genital Tuberculosis in Infertile Women

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