Evaluation of genital tuberculosis as a cause of female infertility in a tertiary care hospital in North India

ABSTRACT

Background: Female genital tuberculosis (FGTB) poses a great diagnostic challenge in women of reproductive age. It causes significant morbidity or short and long term sequelae, especially infertility. The disease often remains silent or may present with non-specific symptomatology. As a result, the prevalence of genital tuberculosis is largely underestimated. A high degree of suspicion aided by intensive investigations is important in the diagnosis of the disease, especially in its early stage, so that treatment may improve the prospects of cure before the tubes are damaged beyond recovery. Objectives were to find out the prevalence of genital tuberculosis in females presenting with infertility in a tertiary care hospital over a given period of time, and diagnostic comparison of endometrial tuberculosis by histopathological examination (HPE) and GeneXpert.Methods: The prospective observational study was conducted over one year duration. A total of 96 endometrial samples were collected from the women, satisfying the inclusion and exclusion criteria.Results: On HPE, out of 96 patients, proliferative endometrium (anovulatory) was found in 38 cases (39.6%), non-specific endometritis in 2 cases (2.08%) and 2 cases (2.08%) were found positive for tubercular endometritis. GeneXpert scored negative in our study.Conclusions: Endometrial biopsy shows not only the tuberculous endometritis, but also gives additional information about local factors of endometrium concerning non-specific and specific infections and anovulatory cycles. GeneXpert if positive on endometrial biopsy is a reliable test for FGTB and treatment can be started on its basis