TB can trigger infertility, if left untreated: warn doctors

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DTMT Network

Tuberculosis (TB) bacterium impacts the lungs, but it can also spread to the uterus and even the fallopian tubes, causing pregnancy complications or infertility, doctors said while sharing their views on pregnancy complications and infertility.

 “Pregnant women can suffer from TB.  Complications of TB include spontaneous abortion, small for date uterus, preterm labor, low birth weight, and increased neonatal mortality. Acquiring an active TB infection in pregnancy can put the mother and baby at risk. But treatment can prevent all the complications. Tuberculosis can affect not only the lungs but many other organs too like bone skin, intestines uterus and fallopian tubes,” Dr Padma Srivastava, Consultant Obstetrician and Gynaecologist, Motherhood Hospitals, Lullanagar, Pune, said.

Dr Bharati Dhorepatil, Consultant infertility expert, NOVA IVF fertility, Pune said, “More often people assume that Tuberculosis is associated with chest because of the commonality in its occurrence. However, it is a multi-organ infection that can affect the brain, liver, bones, and other organs, most importantly reproductive health.”

“In the case of reproductive health, Tuberculosis bacteria(TB bacillus) infect the fallopian tubes and this can lead to blockage of fallopian tubes. Secondly, it affects the uterus lining which leads to thinning of the endometrium lining and scanty menses. The blockage of the fallopian tubes and thinning of endometrium lining leads to fertility issues,” Dr Dhorepatil said.

Dr. Meeta Nakhare, Gynecologist at Lokmanya Hospital said, "Tuberculosis (TB) bacterium mainly takes a toll on the lungs. The symptoms of TB are coughing, chest pain, weight loss, poor appetite, tiredness, fever, night sweats, and chills. TB if left untreated can lead to abortion, preterm labor, low birth weight, ectopic pregnancy, and higher neonatal mortality.”

“Pregnant women with a confirmed diagnosis of TB should initiate treatment without any delay. Maximum cases of infertility are due to TB. Both partners can get affected. Overall immunity is affected and low in women. TB of the uterus may not be symptomatic, but she may come with vague period complaints and no periods / scanty periods,”

“Overall, the patients should be treated. Multi-disciplinary approach with a chest physician, if needed, gives excellent cure rates. However, if patients come late with multi-organ involvement, then Prognosis is poor. Active TB is not a contraindication for the termination of pregnancy. But the anti-TB drugs may cause effects specifically in 1 st trimester. Even though there are many Government programs there is still a taboo related to TB and even after diagnosis patients are reluctant to treatment. We should all take a pledge to eradicate this disease,” Dr Nakhare explained.

Dr Bharati Dhorepatil added, “Genital TB is a silent killer, which many times doesn't show any symptoms except for infertility. There are only a few percentages of patients who come with menstrual irregularities, scanty menses, pelvic pain, and abnormal vaginal discharge. People with weak immunity or diagnosed with diseases like cancer, diabetes, and HIV are at the risk of getting genital Tuberculosis.”

Dr Dhorepatil said that genital TB can lead to spontaneous abortion and ectopic pregnancy. An endometrial biopsy, and menstrual blood culture, can help in diagnosing genital TB. A laparoscopy can help to understand the damage caused to the genital organs.

 “It is essential to tackle genital TB as soon as it is detected. Those with genital TB are treated with ATT (anti-tubercular treatment), which helps in pregnancy if diagnosed earlier. Women with genital TB can conceive with the help of assisted reproductive technologies (ART) like IVF when there is a blockage of tubes and when the lining is very thin. They can be treated only with IVF(test tube baby),” she explained.



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