Genital Tuberculosis and Infertility

Most think of tuberculosis as a respiratory disease, but the truth is that it can affect any part of the body, including the female reproductive system. Genital tuberculosis is a condition that predominantly affects young women and in most cases leads to infertility. Because this condition is difficult to diagnose, it often remains undetected until it has already caused irreversible damage. Therefore, discovering and treating the problem early is essential if there is to be any hope of conception. For women affected by genital tuberculosis, there is some evidence that in-vitro fertilization and embryo transfer are more likely to yield a positive outcome.

Who gets genital tuberculosis?

Genital TB is generally thought of as a condition affecting young woman, with most cases being diagnosed between ages 20 and 40. The condition is especially likely to affect younger women in developing countries, whereas patients in developed countries tend to have a higher average age. Genital TB is suspected when no clear cause of infertility can be found. It becomes much more likely in women who have a family history of tuberculosis or have previously been affected by it themselves.

What are the symptoms of genital TB?

Most women affected by genital TB come to their doctor complaining of infertility. In many cases, no other symptoms are present. Other common symptoms include pelvic pain, irregular bleeding and light or missed periods. Patients may also experience weight loss, fatigue, or vague lower abdominal pain. It is important to note that the symptoms can vary considerably from one patient to another.

How does genital TB affect the reproductive system?

Damage from genital TB almost always begins in the fallopian tubes. One or both tubes may increase in diameter, becoming visibly swollen. Imaging may reveal some lesions and degeneration, but this is not always the case. The next most common site of damage is the endometrium. Damage to the endometrium may not be easily visible due to the regular shedding of the uterine lining. TB of the ovaries and cervix is less common, and it only rarely affects the vulva or vagina.

How does genital TB affect fertility?

Exact numbers vary, but the consensus is that very few women affected by genital TB will be able to have children. Even among those who do manage to conceive, there are often complications that prevent a successful birth. One of the risks is an ectopic pregnancy, which occurs when a fetus is implanted in a location outside of the uterus, such as the fallopian tubes. Women whose genital TB was detected and treated early have the best chance of conception. For women with a history of genital TB, in-vitro fertilization and embryo transfer are recommended.