Having fertility problems? 50% of patients coming for IVF have genital TB

While the Tuberculosis bacteria primarily affects the lungs, it can spread and cause secondary infections to the kidneys, abdomen, brain, uterus and even the fallopian tubes, which can affect chance of pregnancy.

With over 20 lakh cases of Tuberculosis worldwide, India is the second leading country to contribute to the mortality rate. Usually, the TB bacteria affects the lungs, and if left unnoticed, it can also spread throughout the body and cause secondary infections to the kidneys, abdomen, brain, uterus and even the fallopian tubes. Genital TB can be a great cause of concern for both the partners if they are trying to conceive.

With over 20 lakh cases of Tuberculosis worldwide, India is the second leading country to contribute to the mortality rate.(Shutterstock)

“Though the symptoms may not be so evident, the effects can be seen if timely diagnosis is not done. The infections can spread to the uterus and cause thinning of the endometrium, thereby creating a barrier in development of the foetus. TB in females is a chronic disease with low-grade symptoms. Tubal factor infertility along with the involvement of the endometrium is the major cause of infertility. Women are more often affected than males and it can cause irregular menses, vaginal discharge with blood stains, excessive pain during intercourse and sudden pelvic pain. The condition can even mimic other gynecological conditions like ovarian cysts, ectopic pregnancy or even genital cancer,” said Dr Arifa Adil, IVF expert, Indira IVF Hospital, New Delhi.

As per the latest study done by the ICMR, over 50% of female patients coming for IVF procedure have been reported to have genital TB. In over 95% of the cases, the infection was found to affect the fallopian tube, in 50% the endometrium and in 30 % the ovaries.

Though it can occur in any age group (15-45 years) the average age was found to be 31 years. In most of the cases, the disease was asymptotic or present with very few symptoms. Incidents reported in the Delhi-NCR region shows that one in five women with TB were unable to conceive naturally which accounted for 40%.

“Even though it’s difficult to diagnose the presence of TB in the genital tract, there are certain ways to detect them, like a sample of tissue taken from a woman suffering from TB of fallopian tubes. Endometrial tissue is collected from uterus and sent to a lab where the bacteria is grown and later used for testing. The most trustworthy method of diagnosis is making a histological diagnosis of tubercles, which helps doctors on laparoscopy to confirm whether the suspicious lesions are due to tuberculosis or not. Hysterosalpingography (HSG) is also a useful tool in visualising the abnormalities in the uterus and the endometrium. And chronic infections can even lead to narrowing of the uterine cavity,” said gynecologist Dr Arvind Vaid.

The effects can also be seen in post-menopausal women where the condition may be prominent with symptoms of endometrial malignancy, post-menopausal bleeding and persistent vaginal fluid discharge. This is similar in case of affected males where reduction in sperm quality, concentration and motility are a few common traits.

Treating TB with medication can help women conceive through ART, either IVF of or IUI, where intervention can be done to repair the after-effects. One can protect oneself from TB by staying away from crowded areas, where you come into regular contact with people who are infected, have access to proper healthcare and undergo physical exams on a regular basis. You can also get vaccinated against the condition.

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