Diagnosis of Genital Tuberculosis in patients presenting with Infertility in Rural Tertiary Care hospital-A cross sectional study
Tuberculosis (TB) remains a major public health issue affecting millions of people worldwide. Every year, 10 million people suffer from active TB and about 1.33 million die from it. Multidrug-resistant (MDR) and extensively drug-resistant (XDR) TB, which have high morbidity and mortality rates, are particularly concerning. Genitourinary TB accounts for 27.1% of extrapulmonary TB cases, with genitourinary TB occurring in 9% of cases. To study this, the Department of Gynaecology and Obstetrics at SLIMS, Puducherry conducted research on patients with primary and secondary infertility who were suspected of having genital tuberculosis. A detailed clinical history was taken, including the duration of infertility, menstrual and gynecological history, past history of tuberculosis, and systemic examination. All women underwent a detailed laparoscopic examination, and premenstrual endometrial biopsy was taken and sent for AFB microscopy, culture, CBNAAT assay, and histopathological examination. A total of 70 patients were included in the study, of which 50 (71.4%) had primary infertility and 20 (28.6%) had secondary infertility. In the present study, 11 (15.7%) cases had a positive history of extra-genital TB in the past, and family history was positive in 13 (18%) cases. The patients were considered positive or negative for FGTB based on the diagnostic methods used alone or in combination. The study found a significant association between positive past history and laparoscopic findings statistically. None of the 70 samples were smear positive for AFB. Culture was positive in three study subjects, whereas Gene expert was positive in seven cases. HPE samples were positive in 15 cases. Genital Tract tuberculosis is an underestimated disease mainly due to its asymptomatic nature and lack of sensitive tests. It is usually detected when a woman presents with unexplained infertility. Therefore, screening for genital TB should be routinely done for the evaluation of infertility.