Endometrial TB

Genital Tuberculosis

Genital tuberculosis, which is also known as pelvic TB, is caused when the bacteria causing tuberculosis attacks the genital tract, secondary to general tuberculosis. The bacteria spreads through blood or lymphatic routes and mostly affects women during their childbearing period. Its incidence is associated with the overall prevalence of TB in a community. Initially, the bacteria remain silent in the body, and however, later these latent bacilli can get reactivated, and then spread throughout the body through the bloodstream. It then lodges and infects the genital tract and causes genital TB, which can, in turn, cause infertility.

 endometrial-tb signs

Signs and Symptoms

genital TB may not reveal any symptoms.  pain in the lower abdomen, irregular menstruation, and heavy bleeding are common signs in women.

Genital TB causing infertility

The TB bacteria deeply affects the fallopian tubes and the uterine lining and cause irregular menstruation or even stop menstruation cycles. The infections can spread to the uterus and cause thinning of the endometrium, thereby creating a barrier in implantation of the embryo .Tubal factor infertility, along with the involvement of the endometrium, are the major causes of infertility. Therefore, it is necessary to treat the disease quickly; otherwise, the chances of conceiving in the future may become next to nil.

Diagnosis and treatment

Endometrial diagnostic assay and laparoscopy and hysteroscopy are used to evaluate the fallopian tube and the uterine wall.  Specific and sensitive tests for TB and complete blood examination are done to confirm tuberculosis. It is essential to get diagnosed and treated promptly to avoid any severe health complications in the future. After a confirmed diagnosis, the treatment is aimed to kill the bacteria and restore the functionality of damaged reproductive organs to tackle infertility. Full course anti-tuberculosis treatment can manage genital TB, and if the bacteria has caused damage to the reproductive organs, restorative and reconstructive surgery is necessary to make conception possible.

The chances of pregnancy in women suffering from genital tuberculosis is unfortunately very low even after completing the full treatment. But there is always hope for these patients with artificial reproductive technology, mainly IVF treatment.

Authored By : DR RUCHI MALHOTRA, DGO DNB - Obstetrics & Gynecology