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Did you know that tuberculosis can make you infertile? Here’s what you need to know about genital TB

Updated on:24 March 2021, 18:41pm IST
On the Occasion of World Tuberculosis Day, we explain to you how tuberculosis affects the female genital organs. Read on to know more about genital TB
Dr Richa Jagtap
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Tuberculosis could spell doom for your fertility. Image courtesy: Shutterstock
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We often think of tuberculosis as a disease that predominantly impacts the lungs. But did you know TB can also impact the female genitalia? Caused by a bacteria called Microbacillus tuberculosis, genital tuberculosis can potentially lead to infertility.

The exact prevalence of genital TB is difficult to gauge as most afflicted women tend to show no symptoms. And those who are diagnosed are mainly in the young reproductive age group. Genital TB is almost always secondary to TB elsewhere in the body—usually in the lungs and sometimes from other organs. Since the focus is mostly always on the lungs, that the organ heals. But the lesion may lie dormant in the genital tract for years, only to reactivate at a later time, especially due to any other illness, stress, or poor nutrition.

The symptoms of genital tuberculosis

Usually, there are no significant symptoms of genital TB. Hence, the effect of tuberculosis on reproductive organs goes unnoticed till a woman wishes to plan a pregnancy.

The main and most important symptom of genital TB is the inability to conceive. Women may report weight loss, fatigue, and a tendency towards a persistent but mild fever in the evening. Other symptoms can be menstrual irregularities, scanty menses, and low-grade persistent lower abdominal pain.

This is how genital tuberculosis is diagnosed

Imaging diagnostic tools like ultrasound and hysterosalpingography can give important pointers for the diagnosis of tuberculosis. Moreover, laparoscopy findings and tissue culture are some of the gold standard methods for diagnosing TB.

genital TB
Genital TB in females is a chronic disease with low-grade symptoms. Image courtesy: Shutterstock
The treatment for genital tuberculosis

Women with active TB will be referred to an infectious disease specialist and started on treatment. TB is completely treatable with a good and strict medication course.

However, even when the treatment is completed and the germs are eradicated from the body, some of the infection remains. This presents in genital tuberculosis as blockage of fallopian tubes, decreased ovarian function, and formation of adhesions or bands within the womb, between the abdominal organs so much so that it may lead to infertility.

This is how genital TB leads to infertility
  • Fallopian tubes: Did you know that your fallopian tubes are an important organ that helps to pick up the ovulated egg. The egg and sperm fertilise in the tube and the resultant embryo travels in the tube while dividing to reach the womb for implantation. Tubal damage and or blockage can be caused by tuberculosis. This severely affects the chances of conception.  Tubal blockage and widespread adhesion formation are usually not reversible in these patients and most will need in vitro fertilization or IVF to overcome the blockage and help conception. Most of these patients with no other issues will have a healthy chance to conceive.

    genital TB
    Infection of genital tract by tubercle bacillus causes genital TB. Image courtesy: Shutterstock
  • Uterine layer (endometrium): Some women present with very scanty menses. These may have adhesion band formation inside the womb. These adhesion bands make the uterus inhospitable for pregnancy and lead to infertility. This is referred to as Asherman’s syndrome.
  • Ovaries: Any form of infection may lead to compromised blood flow to the affected organs. When an infection affects the ovary and compromises the blood flow, the egg numbers and competence of the eggs get affected. Many such women fail to ovulate spontaneously and respond lesser than anticipated to ovarian stimulation during an IVF process.

It’s very important to correctly diagnose and completely treat genital tuberculosis. Timely medical help can completely cure tuberculosis and ensure fertility potential is not hampered.

Dr Richa Jagtap Dr Richa Jagtap

Dr Richa Jagtap is the clinical director and consultant reproductive medicine, Nova IVF Fertility, Mumbai.