Second-look hysteroscopy after antitubercular treatment in infertile women with genital tuberculosis undergoing in vitro fertilization

Int J Gynaecol Obstet. 2010 Feb;108(2):128-31. doi: 10.1016/j.ijgo.2009.08.031. Epub 2009 Nov 4.

Abstract

Objectives: To assess the efficacy of antitubercular treatment on the uterine cavity in infertile women diagnosed with genital tuberculosis using second-look hysteroscopy.

Methods: A total of 70 women with genital tuberculosis who underwent second-look hysteroscopy were enrolled in the study. They were started on antitubercular drugs and followed up after 6 months of therapy with second-look hysteroscopy. McNemar's chi(2) test was used to compare the hysteroscopy findings before and after antitubercular treatment.

Results: Antitubercular treatment improved hysteroscopy findings in women with thin or flimsy adhesions (grade I), singular dense adhesions (grade II), and occluding adhesions at the internal os (grade IIa) (P<0.01). Patients with extensive adhesions, extensive endometrial scarring, fibrosis, and a tubular cavity showed no improvement after antitubercular treatment. Mean endometrial thickness of the 70 patients on day 21 prior to starting drug therapy was 6.8mm, which increased to 8.1mm after 6 months of treatment.

Conclusion: Considering the exorbitant cost of assisted reproductive technology in low-resource countries, it is necessary to consider reassessment of the uterine cavity prior to beginning such treatment.

MeSH terms

  • Adult
  • Antitubercular Agents / therapeutic use
  • Female
  • Fertilization in Vitro
  • Humans
  • Hysteroscopy
  • Infertility, Female / etiology
  • Prospective Studies
  • Treatment Outcome
  • Tuberculosis, Female Genital / complications
  • Tuberculosis, Female Genital / diagnosis*
  • Tuberculosis, Female Genital / drug therapy
  • Uterine Diseases / complications
  • Uterine Diseases / diagnosis*
  • Uterine Diseases / drug therapy
  • Young Adult

Substances

  • Antitubercular Agents