Ask an Expert Dr. Rupal Shah about Genital Tuberculosis & IVF

Surat, gujarat, May 29, 2015 (Newswire.com) - Tuberculosis is a rampant disease in developing countries like India-and one that cuts across all classes. Tuberculosis of the genital tract occurs quite commonly following tuberculosis infection anywhere else in the body. It mainly spreads through the blood stream to the genital organs. When the infection invades the reproductive system (the genital tract), it commonly targets the fallopian tubes and the uterus and may lower your chances of conception. Women between the age of 20 and 40 years are most susceptible.

Female genital tuberculosis is fast emerging as a major health issue that affects fertility levels in women. Doctors say tuberculosis is a major cause of infection leading to infertility among 25-30% of women in India. There is an increasing trend of genital tuberculosis among women. The infection can attack the ovaries, uterus and tubes leading to infertility problems among women. The disease is also becoming more evident among men causing infertility. Even among men, who are responsible in 50% of infertility cases, tuberculosis is a major reason for infection. Detection and treatment of tuberculosis remains a challenge even as it is one of the oldest diseases impacting Southeast Asian countries including India and Bangladesh, where the bacteria is very rampant.

Is it possible that TB increases the infertility issues in couples?

TB (Tuberculosis) is the infectious disease and infertility is the inability to conceive. Yes TB can cause infertility, but usually it does not show any kind of symptoms until the infection has advanced to a severe level and can affect the infertility in women as well as in men. In the woman it causes tuberculosis in uterus and fallopian tubes where as in the man it cause tuberculosis of epididymo orchitis, as a result of which no sperm can get into the semen.

TB only cause infertility when it infects the genital tract, which is very hard to diagnose and called as genital TB. It affects the fertility of a person by distorting the normal anatomy of the reproductive tract. Genital TB is responsible for infertility in 5-10% of women. The only way to diagnose this TB is by culturing the tubercle bacillus from the tissue and sent it to the lab for testing. While it takes time to grow in lab and by the time it shows positive signs, patient will arrive at an advanced stage.

Genital tuberculosis (GTB) in females is by no means uncommon, particularly in communities where pulmonary or other forms of extra genital TB are common. TB can affect any organ in the body, can exist without any clinical manifestation, and can recur.
Know in detail about Genital Tuberculosis, its symptoms, treatment available and for the investigation procedure at http://www.rupalhospital.com/keyholesurgeryforwomen.html

What is genital tuberculosis?

Tuberculosis or TB is a bacterium which can affect any part of your body, but most often affects the lungs. The primary infection in the lungs is known as pulmonary tuberculosis. In some cases the TB infection moves through the blood to other parts of the body. It can thus cause secondary infections in the genital tract, pelvic area, kidneys, spine and brain. When the bacterium reaches the genital tract it causes genital tuberculosis or pelvic TB. It affects the genital tract (in both men and women), fallopian tubes, uterus, and ovaries. In some cases it also affects the cervix, vagina and vulva. Genital tuberculosis is one of the major causes of tubal disease and female infertility in developing countries.

How does genital TB spread?

If you have low immunity and you spend a long time in close contact with an infected person, then you are most likely to get TB.  Brief contact with an infected person while, say, commuting on buses or trains, watching a movie in a theatre, sharing food, talking or shaking hands, will not give you TB. When a person breathes in the TB bacterium, it settles in the lungs and begins to grow. Women who have pulmonary (lung) TB develop uterine and pelvic TB over a period of time, if it is left untreated. Genital tuberculosis may also spread due to sexual contact with an infected person.

What are the symptoms of genital TB?

Genital TB is usually a silent infection with no apparent symptoms as the bacteria may remain latent in your body for as long as 10 to 20 years. However, some of the symptoms to watch out for include:

•irregular menstrual cycle
•pelvic pain
•vaginal discharge that is stained with blood or which is persistent, heavy and discoloured
•bleeding after intercourse
•infertility

Sometimes, the lack of symptoms makes it difficult to diagnose genital tuberculosis. Depending upon your symptoms, your doctor may advise you to take tests to confirm the diagnosis.

Investigations recommended to confirm genital tuberculosis include Complete blood count, Chest radiographs, Tuberculin test, Menstrual blood for culture, Endometrial curettage, Histologic examination, Culture for Mycobacterium tuberculosis, Peritoneal fluid for culture, Peritoneal biopsy for culture and histology, Hysterosalpingography, Ultrasonography, Cervical cytology, Endoscopy,  Laparoscopy, Hysteroscopy,  Cystoscopy and Other serologic tests.

Learn in detail about investigation procedures and treatment options for Genital Tuberculosis at https://rupalhospital.wordpress.com/category/tb-and-infertility
Treatment Option for genital TB

The treatment for genital TB is the same as for lung TB or any other form of TB. It is a course of antibiotics that lasts about six to eight months. It is important to complete the entire course of the treatment. While the treatment offers relief from pain, fever or discharge, it cannot repair the fallopian tubes, if they have been affected. Therefore, it is advisable to take a second opinion before starting anti-TB medicines. Remember, once you begin the treatment, it will no longer be possible to confirm the diagnosis of TB as the medication will kill the bacteria.

How can genital TB affect my fertility?

In women, genital or pelvic TB usually affects the fallopian tubes causing tubal obstruction, which cannot be reversed. If the TB is diagnosed at an early stage and the infection is treated, the damage to the uterus or fallopian tubes may heal. If left untreated for long, TB in the fallopian tubes, ovaries and uterus may not heal and lead to scarring. Scarring of the uterus usually results in scanty periods. In some, the menstrual periods may completely stop because the uterine lining may be badly affected. Unfortunately, in these cases women may not be able to conceive.

How to screen for tubal scarring?

Several methods can help detect the tubal involvement. Sonography helps in diagnosing pus in the tubes, while hysterosalpingography helps to diagnose blocked tubes. Laparoscopy is a direct visualisation of the tubes giving us an opportunity to take a biopsy from the suspected lesions. TB-PCR from the endometrium or the inner lining of the uterus (a tissue sample is taken and cultured to detect the genetic make-up of the bacteria) is a newer test for diagnosis of tuberculosis. Routine blood tests such as CBC, ESR assist in the diagnosis. Permanent damage may be avoided if anti-tubercular drugs are started in the early phase of the disease.

But if detected late, when the damage is already done, you may have to resort to assisted reproduction. If you have none of the above symptoms, visit a gynaecologist and confirm whether you can plan your pregnancy. If you have trouble getting pregnant within six months, you will need to get yourself investigated. But if you have any of the above symptoms, then it is a good idea to rule out genital tuberculosis at the earliest.

If a family member or colleague is an active TB patient, then people around them need to be cautious and should go for tests like chest X-Ray, tuberculin test to know whether they have been hit by TB or not. Two out of 10 women suffering from TB cannot bear children. 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%. 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.

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. 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.

Various patients neglect the diagnostic test for TB when they are unable to conceive, but it might be the major cause for your infertility problem. So it would be good to test and ensure the root cause of infertility. Rupal Hospital for Women is a premier leader in women's healthcare since 45 long years and is committed in providing women with the highest quality and most advanced healthcare throughout all stages of their lives. The team of doctors at Rupal Hospital believes in the power of information and in spreading education to patients. When the patient is detected with infertility and all test are done, doctors at Rupal hospital advise their patients to go for all test including blood test, Hysterosalpingography, Ultrasonography, Cervical cytology, Endoscopy, Laparoscopy, Hysteroscopy and Cystoscopy. If the patient is detected with genital tuberculosis, they advise them to complete the entire course of the treatment. It is a course of antibiotics that lasts about six to eight months. The team of doctors of Rupal hospital make patients aware that once the course for GTB is over there are chances of achieving normal pregnancy.

You can contact their team of doctors for any information on GTB, how to diagnose GTB, treatment options available for Genital tuberculosis and to know the chances of conceiving after diagnosed with GTB at http://www.rupalhospital.com/index.html