Introduction Tuberculosis (TB) remains a leading global health threat, with increasing concerns regarding post-in vitro fertilization (IVF) TB, especially in high-burden areas. Post-IVF maternal TB poses serious risks to both pregnant women and fetuses, often leading to miscarriage, fetal malformation, or mortality. Congenital TB, though rare, can result from maternal infection, with potentially devastating outcomes. Methods A systematic review of case reports, case series, and cohort studies was conducted following PRISMA guidelines. Databases including PubMed, Scopus, Embase, and Google Scholar were searched until October 7, 2024, for studies related to TB following in vitro fertilization. Cases were evaluated for clinical presentations, diagnostics, treatment, and outcomes. We separately reviewed 11 cohort studies due to the lack of available individual patient data and the considerable variability in their methodologies. Results Thirty-seven reports comprising 48 cases were analyzed, with the majority from Asia. Post-IVF TB is commonly presented as miliary TB in mothers, with systemic involvement including pulmonary, central nervous system (CNS), and genitourinary manifestations. Newborns frequently develop congenital TB, presenting with respiratory distress and neurological issues. The diagnosis was confirmed through techniques such as sputum polymerase chain reaction (PCR), endometrial biopsies, and imaging. Maternal outcomes improved with anti-TB therapy, while neonatal outcomes varied, with high mortality rates. Conclusion Post-IVF TB manifests in mothers as miliary TB with systemic involvement; congenital TB in newborns often leads to respiratory distress, neurological complications, and high mortality. TB screening before IVF is critical in high-risk regions to prevent severe maternal and neonatal complications.
