Infertility Problem Could Be Because of Tuberculosis

Kala (name changed) had been married for over two years. Unable to conceive, she approached the Bangalore Assisted Conception Centre (BACC). In the course of investigation, an endometrial biopsy was recommended, to test the lining of Kala’s uterus.

That test revealed that Kala, only 23 years old, had tuberculosis. Kala belongs to an upper middle class family, and her case contradicts the prevailing notion that tuberculosis is a disease of the poor, the old and the malnourished.

Doctors say that nearly 90% of women with genital tuberculosis (GTB) are diagnosed in the 15-40 years age range. Infertility on account of GTB is 40-80%.

Two out of 10 women suffering from TB cannot bear children, but experts say that with advanced medical treatment now available, if the diagnosis is early enough, GTB can be treated and the woman can regain fertility.

"Kala was treated for nine months for tuberculosis. After completing her course, she conceived naturally. She is now six months pregnant," said Dr Kamini Rao, medical director, BACC.

TB of the uterus and fallopian tubes could also be a cause for infertility. The endometrium lining could be damaged, and get too thin for proper implantation and development of the foetus," explained Dr Rao.

Genital TB is the cause of approximately 10% of all cases of infertility among women in India, and it usually has no symptoms at all, so it goes undetected for long spells of time, Dr Rao said, adding that even if a woman does conceive, she runs a high risk of abortion.

Early detection and standard TB treatment could deal with the problem, doctors say. If diagnosis is late, the damage to the reproductive system could be that much more severe, said experts.

"Once a woman undergoes the course of anti-TB treatment for six to nine months, her chances of conceiving is as good as any other infertile person," said Dr Padmini Prasad, director, Institute of Sexual Medicine.

Dr Rao recounts one case that offers much hope to women with the condition seeking to have children. "Recently, we treated a 42-year-old woman for GTB. She had a 14-year-old son, and approached us for management of secondary infertility. She had had three miscarriages, and irregular menstrual cycles.

She was worried that it could be impending menopause. She was diagnosed with tuberculosis, and treated for nine months. After completing the course, she became pregnant, and is now 10 weeks into her pregnancy."