Menstrual blood versus endometrial biopsy in detection of genital tuberculosis by using nested polymerase chain reaction in an endemic region

Abstract

Aim: The aim of this study is to compare the results of nested polymerase chain reaction (PCR) for early detection of genital tuberculosis (GTB) using menstrual blood (MB) and endometrial tissue (ET) as samples in females presenting as infertility. Methods: The ET and MB samples were collected from a total of 194 females, enrolled in this study. DNA isolation from samples was done using standard, phenol–chloroform method. Heat shock protein gene ( hsp65 / groEL2 ) of Mycobacterium tuberculosis was targeted and amplified, and the final products were analyzed. Results: Overall, 126 (65%) cases of infertility were positive for M. tuberculosis complex by nested PCR. The detection rates in the two samples were statistically insignificant. The combined positivity rate of ET and MB, when compared with positivity rate in MB showed a positive predictive value, negative predictive value, and accuracy of 100%, 68.7%, and 84%, respectively. The results of nested PCR using MB as sample alone showed good agreement with the nested PCR results of the combined samples. Conclusions: The hsp65 Nested PCR of MB can be used as a noninvasive screening test for early diagnosis of GTB.

Case report of pelvic tuberculosis resulting in Asherman’s syndrome and infertility

“…Endometrial biopsy can be collected for histology and culture as well as staining for acid-fast bacilli and mycobacterial culture. Interestingly, menstrual fluid is more sensitive than biopsy specimens for the diagnosis of TB endometritis [9]. However, it should be noted that this mode of culturing may not be possible when amenorrhea has resulted from the infection.…”