Endometrial Tuberculosis Pick By PCR; in Female Infertility

"To evaluate the usefulness of PCR in diagnosing genital tuberculosis in female infertility and its sensitivity,specificity, positive predictive value, negative predictive value and its edge over other diagnostic modalitieslike histopathological examination and culture. This study included 100 infertile women who met the inclusionand exclusion criteria. After a detailed history, clinical examination and investigations, endometrial curettingswere taken in premenstrual phase and sent for culture, histopathological examination and PCR. Afterevaluation the results were compared individually with each other or in combination to see the positive pickup percentage and their sensitivity and specificity. We found 4% cases positive for tuberculosis on culturefor Mycobacterium tuberculosis, 7% of cases positive histopathologicaly and 15% cases on PCR evaluation.The sensitivity for diagnosing this disease was found highest in PCR (100%) followed by histopathologicalexamination (75%). Culture had the least sensitivity of 42.85%. PCR represents a rapid and sensitivemethod for identification of Mycobacterium DNA in female genital tuberculosis. Culture and histopathologyhave low sensitivity compared to PCR. Therefore, when the clinical suspicion is high and culture andhistopathology is negative, PCR is the method of choice for identifying the infection."

Outcome of In Vitro Fertilization and Embryo Transfer in Infertile Women with Pelvic Tuberculosis / 대한불임학회지

OBJECTIVES: Pelvic tuberculosis (TB) causes infertility despite of anti-TB chemotherapy and IVF-ET is effective treatment to achieve pregnancy. The aim of this study is to assess the outcomes of IVF-ET in pelvic TB, especially according to main Tb lesion, and to investigate the factors affecting the successful outcome. METHODS: A total of 135 IVF-ET cycles were performed in 54 patients with pelvic TB and the outcome was compared with that of control group with tubal factor not associated with TB in 301 cycles, 227 patients. Anti-TB chemotherapy was performed in the patients with pelvic TB. Pregnancy rate was compared according to main TB lesion as salpingitis, peritonitis, and endometritis. In the patients with endometrial TB, when complicated with uterine synechia, hysteroscopic lysis was done before IVF-ET and pregnancy rate was compared according to the presence of uterine synechia. RESULTS: There was no significant difference in peak E2 (2,790+/-280.1 vs 2,554+/-101.2, p>0.05), the number of retrieved oocytes (13.5+/-0.7 vs 12.5+/-0.4, p>0.05) and fertilized oocytes (7.7+/-0.5 vs 7.8+/-0.3, p>0.05) between patient and control group. Clinical pregnancy rate per transfer in pelvic TB group was 22.9% and showed no difference from that of control group (24.3%, p>0.05). Although it was not statistically significant, pregnancy rate in the endometrial Tb (18%) was lower than that in the salpingitis (28.5%) or peritonitis (26.5%) (p>0.05). In the endometrial TB with uterine synechia, pregnancy rate was significantly lower than that of the patients without synechia even after hysteroscopic lysis (9.7% vs 31.6%, p<0.05). CONCLUSION: IVF-ET after anti-TB chemotherapy is the most effective treatment to achieve pregnancy in infertile patients with pelvic TB. Because the presence of endometrial TB and resulting uterine synechia affects the outcome of IVF-ET, thorough evaluation for endometrium with endometrial biopsy and hysteroscopy is important to predict the prognosis of IVF-ET treatment.

Outcome of In Vitro Fertilization and Embryo Transfer in Infertile Women with Pelvic Tuberculosis / 대한불임학회지

OBJECTIVES: Pelvic tuberculosis (TB) causes infertility despite of anti-TB chemotherapy and IVF-ET is effective treatment to achieve pregnancy. The aim of this study is to assess the outcomes of IVF-ET in pelvic TB, especially according to main Tb lesion, and to investigate the factors affecting the successful outcome. METHODS: A total of 135 IVF-ET cycles were performed in 54 patients with pelvic TB and the outcome was compared with that of control group with tubal factor not associated with TB in 301 cycles, 227 patients. Anti-TB chemotherapy was performed in the patients with pelvic TB. Pregnancy rate was compared according to main TB lesion as salpingitis, peritonitis, and endometritis. In the patients with endometrial TB, when complicated with uterine synechia, hysteroscopic lysis was done before IVF-ET and pregnancy rate was compared according to the presence of uterine synechia. RESULTS: There was no significant difference in peak E2 (2,790+/-280.1 vs 2,554+/-101.2, p>0.05), the number of retrieved oocytes (13.5+/-0.7 vs 12.5+/-0.4, p>0.05) and fertilized oocytes (7.7+/-0.5 vs 7.8+/-0.3, p>0.05) between patient and control group. Clinical pregnancy rate per transfer in pelvic TB group was 22.9% and showed no difference from that of control group (24.3%, p>0.05). Although it was not statistically significant, pregnancy rate in the endometrial Tb (18%) was lower than that in the salpingitis (28.5%) or peritonitis (26.5%) (p>0.05). In the endometrial TB with uterine synechia, pregnancy rate was significantly lower than that of the patients without synechia even after hysteroscopic lysis (9.7% vs 31.6%, p<0.05). CONCLUSION: IVF-ET after anti-TB chemotherapy is the most effective treatment to achieve pregnancy in infertile patients with pelvic TB. Because the presence of endometrial TB and resulting uterine synechia affects the outcome of IVF-ET, thorough evaluation for endometrium with endometrial biopsy and hysteroscopy is important to predict the prognosis of IVF-ET treatment.

A Case of Endometrial Tuberculosis with coexisting Adenocarcinoma of the Endometrium / 대한산부인과학회잡지

The association of carcinoma and tuberculosis in any organ is rare and in the endometrium is extremely rare. Only a small number of cases of endometrial tuberculosis with coexisting endometrial adenocarcinoma have been reported in the literature. We experienced a case of endometrial tuberculosis with coexisting endometrial adenocarcinoma and report with a brief review of literature.