Genital tract tuberculosis among infertile women: an old problem revisited

To estimate the prevalence of genital tract tuberculosis (TB) among infertile women during laparoscopic evaluation for infertility in a prospective observational study.

A total of 420 infertile women were included. All patients had laparoscopy and all suspicious lesions were biopsied and peritoneal fluids aspirated. Full endometrial curettage followed by histopathological examination was done for specimens. Polymerase chain reaction test (PCR) was performed for all peritoneal fluid samples and tissue biopsy.

Genital tract tuberculosis was diagnosed with laparoscopy and confirmed by tissue biopsy in 24 patients (5.7%). Visual laparoscopic findings and direct tissue biopsy had the highest sensitivity and specificity (92-94%, respectively) followed by PCR (83-85%) and lastly endometrial biopsy (75-80%) for diagnosis of genital tuberculosis. The incidence of genital tuberculosis was higher among rural patients with low socioeconomic and educational levels.

Genital tuberculosis has a role in the etio-pathogenesis of infertility. Laparoscopy and direct tissue biopsy are the gold standards for its diagnosis.