Genital tuberculosis can lead to infertility in women, reveals study

Scientists said this is for the first time that a link between latent TB and low egg reserve has been established.

Genital tuberculosis, which is dormant in uterus, decreases a woman’s egg count leading to infertility, revealed a new study published in medical journal Human Reproduction on June 14.

Results showed that women who underwent standard anti-TB treatment had significant improvement in pregnancy rates. (HT file)

Scientists said this is for the first time that a link between latent tuberculosis (TB) and low egg reserve has been established, thus answering why in vitro fertilisation (IVF) may fail for women suffering from genital tuberculosis. Study showed around 40% infertile women have latent genital TB infection.

Researchers said while small-scale studies had already shown that latent TB decreases the thickness of uterus, but no prior studies had checked if the infection also affected ovaries.

“If the dormant bacteria were affecting the uterus, there was no reason to believe it wouldn’t affect ovaries. Success rate of pregnancies is directly proportional to the egg reserve. Our findings show that dormant TB bacterium also affects the ovaries,” said Dr Padma Rekha Jirge, scientific director, Sushrut IVF Clinic, Kolhapur, the lead author. “It seems that latent TB bacterium alters the environment in an ovary, leading to poor egg quality.”

To estimate the egg reserve, researchers measured anti-Mullerian hormone (AMH) levels, which indicate a woman’s egg reserve. The hormone is produced by the ovaries. Women with TB had 30% lower AMH compared to women without the infection, the study revealed.

Moreover, the results showed that women who underwent standard anti-TB treatment had significant improvement in pregnancy rates. The pregnancy rates improved to 51.6% for women who underwent anti TB treatment compared to 40.5% who didn’t receive the treatment. However, there was no improvement in the egg count.

Deepak Modi, scientist at National Institute of Research in Reproductive Health, Indian Council of Medical Research (ICMR), Parel, said the study suggests that many women with latent genital TB, may be able to conceive without IVF.

“If latent TB is diagnosed and treated, some women may conceive with their own eggs and may not need IVF or egg donation,” he added.

Modi said there is a need to improve detection rates of latent genital TB, so that women can be put on treatment at the earliest.

Active genital TB is the most common form of extra pulmonary TB, yet has detection rate as low as 7% to 19%, according to previous studies, the authors said.