Diagnosis of Genital Tuberculosis in Infertile  Women: A Comparative Study from a Tertiary  Care Centre

Sangram  Keshari Jena; Shalini  Bhushan; Farooq  Ahmad Dar; Jugal Kishor  Agarwal; Merajul  Haque  Siddiqui

Sangram Keshari Jena Department of Microbiology, Rama medical College hospital and research centre, Hapur, Uttar Pradesh, India.
Shalini Bhushan Department of Microbiology, Rama medical College hospital and research centre, Hapur, Uttar Pradesh, India.
Farooq Ahmad Dar Department of Microbiology, Rama medical College hospital and research centre, Hapur, Uttar Pradesh, India.
Jugal Kishor Agarwal Department of Microbiology, Rama medical College hospital and research centre, Hapur, Uttar Pradesh, India.
Merajul Haque Siddiqui Department of Microbiology, Rama medical College hospital and research centre, Hapur, Uttar Pradesh, India.

Keywords: Infertility, Tuberculosis, Genital

Abstract

Introduction: Female genital tuberculosis (FGTB) is a significant cause of infertility, particularly in TB-endemic regions. Primarily affecting young women, FGTB can lead to serious complications in reproductive organs. Prevalence data is often elusive, with rates ranging from 1% in some countries to 48.5% among infertile women in northern India.
Materials and Method: This study included 80 women with unexplained infertility and suspected genital tuberculosis (GTB). Imaging techniques (ultrasonography, hysterosalpingography, hysteroscopy, and
laparoscopy) were used to identify GTB indicators. The Interferon Gamma Release Assay (IGRA) assessed latent TB infection. Endometrial biopsies were processed for GeneXpert, polymerase chain reaction (PCR), and culture tests. Diagnostic accuracy was evaluated by calculating sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV).
Results: This study assessed 80 women suspected of GTB, with a mean age of 29.4 years; 72% had primary infertility. Clinical symptoms were present in 55% of cases, including menstrual irregularities (30%) and chronic pelvic pain (20%). Imaging findings showed GTB-related abnormalities in 45% (ultrasonography) and tubal abnormalities in 69% (hysterosalpingography). Laparoscopy indicated GTB in 40% of the women examined.
Laboratory diagnostics revealed IGRA positivity in 56.5% (sensitivity: 80%, specificity: 95%), GeneXpert in 24% (sensitivity: 60%, specificity: 100%), PCR in 29% (sensitivity: 72%, specificity: 100%), and histopathology in
32% (sensitivity: 70%, specificity: 100%). Combining IGRA, GeneXpert, and histopathology improved diagnostic yield to 85% in inconclusive imaging cases.
Conclusion: The study highlights the value of a multimodal diagnostic approach for detecting GTB in infertile women. Integrating clinical evaluations, imaging, and laboratory tests significantly enhances diagnostic accuracy, warranting further research to refine these methods and improve reproductive outcomes for women affected by GTB.

How to cite this article:
Jena K S, Bhushan S, Dar A F, Agarwal K J, Siddiqui
H. Diagnosis of Genital Tuberculosis in Infertile
Women: A Comparative Study from a Tertiary
Care Centre. J Commun Dis. 2024;56(4):8-13.

DOI: https://doi.org/10.24321/0019.5138.202464

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