Effect of antitubercular treatment on the pregnancy outcomes and prognoses of patients with genital tuberculosis

Abstract

This retrospective study aims to demonstrate the effect of antitubercular treatment (ATT) on the pregnancy outcomes and prognoses of patients with genital tuberculosis (GTB) who had received laparoscopy and/or hysteroscopy. This study included 78 patients with infertility and who were diagnosed with GTB through laparoscopy and/or hysteroscopy over the period of November 2005 to October 2015. The recruited patients were divided into ATT and nonATT groups on the basis of ATT duration. The GTB recurrence rates, menstrual patterns, and pregnancy outcomes of the patients were determined at follow-up. Among the 78 patients, 46 received ATT and 32 did not receive ATT. The menstrual volumes of patients in the ATT group significantly decreased relative to those of patients in the nonATT group. GTB did not recur among all patients regardless of treatment. A total of 11 pregnancies (36.7%) in the ATT group and 19 pregnancies (63.3%) in the nonATT group were observed. Pregnancy rates significantly differed (P = 0.002) between the two groups. ATT may decrease the menstrual volume and pregnancy rates of patients who were diagnosed with GTB through laparoscopy and/or hysteroscopy. In addition, ATT did not improve the prognosis of patients with chronic GTB.

Keywords

antitubercular treatment / pregnancy / prognosis / genital tuberculosis

References

[1] Schaefer G. Female genital tuberculosis. Clin Obstet Gynecol 1976; 19(1): 223–239

[2] Malkani PK, Rajani CK. Pelvic tuberculosis. Obstet Gynecol 1959; 14: 600–611

[3] Tinelli A, Malvasi A, Vergara D, Martignago R, Nicolardi G, Tinelli R, Pellegrino M. Abdominopelvic tuberculosis in gynaecology: laparoscopical and new laboratory findings. Aust N Z J Obstet Gynaecol 2008; 48(1): 90–95

[4] Jindal UN, Bala Y, Sodhi S, Verma S, Jindal S. Female genital tuberculosis: early diagnosis by laparoscopy and endometrial polymerase chain reaction. Int J Tuberc Lung Dis 2010; 14(12): 1629–1634

[5] Eftekhar M, Pourmasumi S, Sabeti P, Aflatoonian A, Sheikhha MH. Mycobacterium tuberculosis infection in women with unexplained infertility. Int J Reprod Biomed (Yazd) 2015; 13(12): 749–754

[6] Bhanothu V, Theophilus JP, Reddy PK, Rozati R. Occurrence of female genital tuberculosis among infertile women: a study from a tertiary maternal health care research centre in South India. Eur J Clin Microbiol Infect Dis 2014; 33(11): 1937–1949

[7] Sharma JB, Sneha J, Singh UB, Kumar S, Roy KK, Singh N, Dharmendra S, Vanamail P. Comparative study of laparoscopic abdominopelvic and fallopian tube findings before and after antitubercular therapy in female genital tuberculosis with infertility. J Minim Invasive Gynecol 2016; 23(2): 215–222

[8] Sharma JB, Sneha J, Singh UB, Kumar S, Roy KK, Singh N, Dharmendra S, Sharma E, Sharma A. Effect of antitubercular therapy on endometrial function in infertile women with female genital tuberculosis. Infect Disord Drug Targets 2016; 16(2):101–108

[9] Neonakis IK, Spandidos DA, Petinaki E. Female genital tuberculosis: a review. Scand J Infect Dis 2011; 43(8): 564–572

[10] Deans R, Abbott J. Review of intrauterine adhesions. J Minim Invasive Gynecol 2010; 17(5): 555–569

[11] Jindal UN, Verma S, Bala Y. Favorable infertility outcomes following anti-tubercular treatment prescribed on the sole basis of a positive polymerase chain reaction test for endometrial tuberculosis. Hum Reprod 2012; 27(5): 1368–1374

[12] Jindal UN, Bala Y, Sodhi S, Verma S, Jindal S. Female genital tuberculosis: early diagnosis by laparoscopy and endometrial polymerase chain reaction. Int J Tuberc Lung Dis 2010; 14(12): 1629–1634

[13] Rana T, Singh UB, Kulshrestha V, Kaushik A, Porwal C, Agarwal N, Kriplani A. Utility of reverse transcriptase PCR and DNA-PCR in the diagnosis of female genital tuberculosis. J Med Microbiol 2011; 60(Pt 4): 486–491

[14] Parikh FR, Nadkarni SG, Kamat SA, Naik N, Soonawala SB, Parikh RM. Genital tuberculosis — a major pelvic factor causing infertility in Indian women. Fertil Steril 1997; 67(3): 497–500

[15] Kulshrestha V, Kriplani A, Agarwal N, Singh UB, Rana T. Genital tuberculosis among infertile women and fertility outcome after antitubercular therapy. Int J Gynaecol Obstet 2011; 113(3): 229–234

[16] Caliskan E, Cakiroglu Y, Sofuoglu K, Doger E, Akar ME, Ozkan SO. Effects of salpingectomy and antituberculosis treatments on fertility results in patients with genital tuberculosis. J Obstet Gynaecol Res 2014; 40(10): 2104–2109

Compliance with ethics guidelines

Jing Yue, Bo Zhang, Mingyue Wang, Junning Yao, Yifan Zhou, Ding Ma, and Lei Jin declare that no conflict of interest. Diagnosis was conducted on the basis of pathological and/or biopsy specimens from the endometrium or pelvic cavity. The relevant institutional ethics committees approved the research protocol. All participants provided informed consent.

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2018 Higher Education Press and Springer-Verlag GmbH Germany, part of Springer Nature