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Tuberculosis

TB and IVF

03/29/2011

Question:

I had 2 ectopic pregnencies and both my fallopian tubes removed. Later it was found that I had TB. I was given 6 months treatment with ATK4, R-CINIX, BENEDON, BEROCIN, after which I had IVF which failed. Again I was tested for TB and found positive. I was given AKT3 for 4 months, after which i was given ivf which failed again. My question: is there any test to perfectly know if the TB is cured completly? Please help.

Answer:

Tuberculosis (TB) causing infertility is referred to as genital TB. Genital TB is very hard to diagnose because it is very difficult to culture Mycobacterium tuberculosis (the bug that causes TB disease) from the genital tract. I am not sure how your diagnosis of TB was made when they initially removed the fallopian tubes. Was it with culture or biopsy results? If a culture was performed, did they get drug susceptibility testing results (so that you know the medication you received was effective, i.e. no drug resistance was found)?

Genital TB can affect the fallopian tubes but it can also affect the endometrium (lining of the uterus). So, after your fallopian tubes were removed, how were you tested positive again for TB: culture or biopsy?

A tuberculin skin test (TST) or interferon gamma release assay (blood test) for TB can remain positive despite adequate treatment for TB disease. There is no test that can indicate that you are completely cured of TB disease. For patients with active TB disease, the symptoms of TB will resolve. For example in patients with TB of the lung, they are no longer coughing or having fevers or chills. Their chest radiograph may improve and their sputum culture will be negative.

For the case of genital TB, you may be cured of the active TB disease after completing TB treatment. But, because of the damage that TB has caused, one may not be able to become pregnant. It is best to seek medical advice from a TB and OB-GYN specialist to determine the reason why the in vitro fertilization is not successful in your case.

For more information:

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Response by:

Shu-Hua   Wang, MD, MPH&TM Shu-Hua Wang, MD, MPH&TM
Clinical Assistant Professor of Infectious Diseases
Clinical Assistant Professor of The Division of Epidemiology
College of Medicine
The Ohio State University

Larry S Schlesinger, MD Larry S Schlesinger, MD
Professor:
Molecular Virology, Immunology and Medical Genetics
Microbiology Administration
Environmental Health Sciences
College of Medicine
The Ohio State University