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    pink loader
    fertility basics

    Know the link between Genital Tuberculosis and Infertility - Causes, Symptoms, Treatments

    • 169456 views
    • 4.8   (5 Votes)

    Genital Tuberculosis and Infertility are linked to each other. Symptoms of genital tuberculosis in females are weight loss, menstrual and infertility problems, and painful intercourse. Treatment of genital tuberculosis includes antibiotics therapy for a span of 6 to 9 months to prevent any further damage to the health of the individual.

    Since thousand years, Tuberculosis exists in developing countries like India. It has plagued many and surged great epidemics by behaving like other infectious diseases. Tuberculosis is a serious bacterial infection which directly affects the lungs along with the other body part because of Mycobacterium tuberculosis bacteria. The bacteria are responsible for causing tuberculosis spread from one person to another through the released tiny droplets into the air while sneezing and coughing. It means it can easily spread from an infected person to someone else who is not infected. (1)

    What is Pulmonary Tuberculosis?

    Pulmonary Tuberculosis is a type of tuberculosis, which is caused because of contagious bacterial infection in the lungs. Once you are infected with TB, it moves through the blood to the other parts of the body. Most people recover from primary TB infection without any further disease evidence. This infection might stay inactive for years while in some cases it can get active again. (2)

    TB further causes secondary infections in the kidney, genital tract, pelvic area, spine, and brain. When the bacterium reaches the genital tract it causes genital tuberculosis or pelvic TB. In both male and female, it affects the genital tract, uterus, fallopian tubes and ovaries. While in other cases it might also affect the cervix, vagina, and vulva.

    What is Genital Tuberculosis?

    The female age group which is prone to this disease are between the age of 20 and 40 years. Genital TB is responsible for infertility in 5-10% of all women around the globe. It affects the reproductive organs of females like the fallopian tube, ovary, uterus, etc. In men, it affects the prostate gland and testes, kidneys, ureters and urinary bladder (in both male and female). It mainly affects women during pregnancy and is usually detected incidentally during infertility treatment. (3)

    Genital Tuberculosis

    How does TB affect fertility?

    Although the initial exposure to tuberculosis is through the lungs as bacillus is inhaled but most of us fight the disease and it remains inactive in the body, causing no harm. But sometimes, the latent bacilli reactivate and spread through the bloodstream into the entire body. It can get deposited in any part of the body causing infection. It comes into the picture when it can get deposited and infects the genital tract to cause infertility. (4)

    • In males, it causes tuberculous epididymo-orchitis which blocks the passage and hence leads to azoospermia (where no sperm enters the semen because of the blocked track) in males.
    • In the case of women, it causes tuberculous endometritis (uterus infection) and salpingitis (tubes infection)which lowers the chance of conception.
    • If fallopian tubes get affected due to TB, then it causes structural and functional damage which also includes tubal obstruction.
    • Uterus TB can cause damage to the inner lining called the endometrium which results in scanty periods and infertility. While in some situations, the menstrual periods may completely stop due to the badly affected uterine lining.

    The TB is diagnosed by performing the culture of the tubercle bacillus from the tissue and then it is sent to the lab for testing.

    What are the symptoms of Genital TB?

    Being a silent infection, Genital TB shows no apparent symptoms because the bacteria may remain inactive in the body for 10 to 20 years. However, there are some of the symptoms to look out (5):

    • Systemic symptoms such as Fatigue, Weight loss, and Low-grade fever
    • Menstrual Disturbances
    • Amenorrhea (Absence of periods)
    • Menorrhagia (Heavy bleeding at menstruation)
    • Metrorrhagia (Abnormal bleeding from the uterus)
    • Oligomenorrhea (Infrequent periods)
    • Swelling in the lower abdomen

    Swelling in lower abdomin

    Sometimes, due to lack of undetectable symptoms, it becomes difficult to diagnose genital tuberculosis. The doctor will advise you to go for a diagnosis after seeing your above-mentioned symptoms and signs.

    Diagnosis of TB

    The analysis is done to confirm genital tuberculosis where the test includes (6) (7)

    • Complete blood count
    • Chest radiographs
    • Tuberculin test

    Tuberculin test

    • Endometrial curettage
    • Menstrual blood for the culture
    • Culture for Mycobacterium tuberculosis
    • Histological examination
    • Peritoneal fluid for culture
    • Hysterosalpingography
    • Peritoneal biopsy for culture and histology
    • Ultrasonography
    • Endoscopy
    • Cervical cytology
    • Laparoscopy

    Laparoscopy

    • Hysteroscopy
    • Cytoscopy

    How to detect Tubal Scarring?

    There are several ways of detecting tubal involvement.

    • Sonography: It helps in detecting the pus in the tubes. (9)
    • Hysterosalpingography: It helps in diagnosing the blocked tubes. (10)
    • Laparoscopy: It provides direct visualization of tubes and helps in taking the biopsy from suspected lesions.
    • TB-PCR: It is a new test for diagnosing tuberculosis. In this test, the tissue is taken from the endometrium or the uterus’s inner lining which is then cultured for detecting the genetic makeup of bacteria.
    • For assisting in the diagnosis process, routine blood tests like CBC and ESR are done.

    Routine blood test

    If a patient has started the use of anti-tubercular drugs in the early phase of disease then there are chances of minimizing the permanent damage.

    But if the disease is detected at the later stage then it is advised to resort to assisted reproduction depending upon the extent of damage to the genital parts.

    Visit a gynecologist if you don’t have any of the above symptoms and confirm whether you are able to conceive. You need to get yourself diagnosed if you are unable to get pregnant within six months of trying actively for a baby.

    And if you notice any of the above signs then it is better to treat genital tuberculosis as early as possible.

    Treatment Options for genital TB

    • Genital TB treatment includes a course of antibiotics and medication which lasts for about 6 to 9 months. To minimize the high chances of infection relapsing, it is important to complete the entire course of the treatment. (8)
    • Once the TB is detected and initiated early, then it is possible to deal with the problem with the right treatment. But if the diagnosis is performed late, then there can be severe and irreversible damage to the reproductive system. Once the anti-TB treatment course is completed then there are good chances of conceiving as any other infertile person.

    Genital TB is the cause of infertility among 10% women and doesn’t show any symptoms at all. There are high chances of abortion even if a woman conceives. So, early detection followed by standard treatment can solve the problem. But if diagnosed late, there are chances of reproductive system damage. And once the woman starts the anti-TB treatment course for 6 to 9 months, her pregnancy chances are high in comparison to the infertile women.

    Couples who are looking forward to pregnancy and trying for more than 6 months with no positive results are advised to go through Genital TB test. Also, get to know to try to conceive tips to fasten your process of conceiving.

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    5 Comments

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    Yasmeen Wahida

    Please suggest me with some best place for genital tuberculosis treatment.

    Oct. 10, 2018, 6:56 p.m. 4.5

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    Sandhya Mehta

    I have a mensurational disturbance like sometimes heavy bleeding and another month no bleeding at all since one year. The symptoms like abdominal swelling are rare. Do I need treatment for genital tuberculosis or is it normal?

    Sept. 11, 2018, 3:51 p.m. 5.0

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    Alicia Wolf

    Had no idea about this thing called genital TB. Nice read!

    June 4, 2018, 4:02 p.m. 5.0

    user_img

    Sadhana Baxi

    I never knew TB can lead us to infertility. Thanks for sharing this.

    May 23, 2018, 7:44 p.m. 5.0

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    Pandurang Rukhamaji Uchitkar

    May 17, 2018, 9:41 p.m. 4.5

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