Frequency of Genital Tuberculosis in Patients Undergoing Diagnostic Laparoscopy for Infertility

OBJECTIVES: To determine the frequency of genital tuberculosis in patients undergoing diagnostic laparoscopy for infertility. METHODOLOGY: It is a descriptive (cross-sectional) prospective study. The study was performed within the duration of six months i.e., February 12th, 2020 to August 12th, 2020 at the Department of Obstetrics and Gynecology, Khyber Teaching Hospital, Peshawar. A total of 196 patients were observed by using 47.1% proportion of genital tuberculosis in infertility, 95% confidence interval with margin of error 7%, using software of WHO for sample size calculation. Further, sample collection was performed using non-probability (consecutive) sampling techniques. RESULTS: The mean age of the patients in our study was 30 years (SD+3.92). Fifty seven percent of cases were having primary infertility and 43% of patients were having secondary infertility. The incidence of genital tuberculosis undergoing infertility was 45%. CONCLUSION: Our study concludes that the incidence of genital TB in infertility in our setup was 45%.

RURAL HOSPITAL CORRELATION OF CLINICAL PRESENTATION, HISTOPATHOLOGY, AND POLYMERASE CHAIN REACTION FOR GENITAL TUBERCULOSIS DIAGNOSIS

In India, vaginal tuberculosis (FGTB) is a common cause of infertility, but diagnosis is difficult because of the form of the disease of people in need. Traditional diagnostic methods include the detection of rapid bacilli acid in endometrial or peritoneal biopsy, epithelioid granuloma biopsy, or a positive Expert type in biopsy, although this is only available in a small percentage of cases, leaving patients many are not available. Diagnosis of GTB by PCR along with histopathological findings leads to high sensitivity and specificity. So, both diagnostic and operative laparoscopy and hysteroscopy are the modalities essential for management of genital TB in infertile women. This review discusses various diagnostic modalities including endometrial or peritoneal biopsy to detect epithelioid granuloma on microscopy, role of PCR for GTB and correlation of two for early diagnosis of genital tuberculosis so that management will be started at early stage which can prevent patient from getting permanent damage to organs. Tuberculosis being endemic in counties likes India; it is often a leading cause of infertility. Early diagnosis is crucial because, by the time patient reports with infertility, already the damage has started and reverting tubal patency is almost impossible. Early diagnosis typically fails in developing countries, primarily because there are no pathognomonic signs of the disease and either poor sensitivity or procedurally invasive diagnostic methods are in use.

Birth of a healthy infant after bone marrow-derived cell therapy

Bone marrow-derived cell (BMDC) therapy has numerous applications as potential biological cells for use in regenerative medicine. Here, we present an original case of endometrial atrophy associated with genital tuberculosis in a woman who achieved a live birth with BMDC. This 27-year-old woman came to our center with endometrial atrophy and primary infertility. She had a past history of genital tuberculosis and amenorrhea. Her husband’s semen quality was normal. The patient was counseled for hysteroscopy due to thin endometrium and advised in vitro fertilization (IVF) with donor eggs in lieu of poor ovarian reserve. Several attempts of IVF with hormone replacement therapy (HRT) were made, but the desired thickness of the endometrium was not achieved. Uterine artery injection of BMDC through interventional radiology was given, followed by HRT for three months, which resulted in improved endometrium. This was subsequently followed by IVF with donor egg. The treatment resulted in the conception and delivery of a 3.1-kg baby boy through lower segment caesarean section with no antenatal, intranatal or postnatal complications. Recently, there has been massive interest in stem cells as a novel treatment method for regenerative medicine, and more specifically for the regeneration of human endometrium disorders like Asherman syndrome and thin endometrium, which was the reason behind using this strategy for treatment.

A STUDY ON CO-RELATION BETWEEN INFERTILITY AND FEMALE GENITAL TUBERCULOSIS

Background: Female genitourinary tuberculosis (FGTB) is an important cause of infertility in women of reproductive age group. The disease remains undetected due to its asymptomatic nature and lack of sensitive tests. This study was conducted with the aim of detecting the prevalence of genital tuberculosis in infertile women. Aim And Objectives: To evaluate the rate of female genital tuberculosis in patients of infertility. Method And Materials: Questionnaire survey was done among 100 infertile women in 6 months from May 2020 to October 2020. Females of reproductive age group from 18 years to 35 years with the duration of infertility of more than 2 years were included. Results: Total 100 infertile females were included in the study. Out of 100 subjects, 81 cases had primary infertility & 19 had secondary infertility. There was positive history of extra genital TB in past in 30 cases and family history was positive in 26 cases. FGTB was diagnosed in 14 females in past on basis of diagnostic methods used in alone or in combination. Conclusion: FGTB is common in our population and women presenting with infertility should be evaluated for genital tuberculosis. A high degree of suspicion and combination of histopathological and microbiological tests are important methods for the detection of genital tuberculosis

A Case of Genital Tuberculosis Presenting as HSIL on Cervical Biopsy

Genital tuberculosis is a frequent cause of chronic PID and infertility. Cervical TB is rare in postmenopausal women. We present a case of a post menopausal patient, who presented with a complaint of blood mixed discharge per vaginum for six months. Her preliminary investigations were consistent with that of HSIL/ High grade cervical dysplasia. Upon further evaluation, histopathological examination confirmed the possibility of tuberculosis instead. Key words: HSIL, Genital tuberculosis, Cervical biopsy.