‘Gen­i­tal TB de­creases egg count, leads to in­fer­til­ity’

48% in­fer­tile women have la­tent gen­i­tal tu­ber­cu­lo­sis

Hindustan Times ST (Mumbai) - - HTMETRO - Aayushi Pratap

MUM­BAI: Gen­i­tal tu­ber­cu­lo­sis, which is dor­mant in uterus, de­creases a woman’s egg count lead­ing to in­fer­til­ity, re­vealed a new study pub­lished in med­i­cal jour­nal Hu­man Re­pro­duc­tion on June 14.

Sci­en­tists said this is for the first time that a link be­tween la­tent tu­ber­cu­lo­sis (TB) and low egg re­serve has been es­tab­lished, thus an­swer­ing why in vitro fer­til­sa­tion (IVF) may fail for women suf­fer­ing from gen­i­tal tu­ber­cu­lo­sis.

Study showed around 48% in­fer­tile women have la­tent gen­i­tal TB in­fec­tion.

Re­searchers said while small scale stud­ies had al­ready shown that la­tent TB de­creases the thick­ness of uterus, but no prior stud­ies had checked if the in­fec­tion also af­fected ovaries.

“If the dor­mant bac­te­ria were af­fect­ing the uterus, there was no rea­son to be­lieve it wouldn’t af­fect ovaries. Suc­cess rate of preg­nan­cies is di­rectly pro­por­tional to the egg re­serve. Our find­ings show that dor­mant TB bac­terium also af­fects the ovaries,” said Dr Padma Rekha Jirge, sci­en­tific di­rec­tor, Sushrut IVF Clinic, Kol­ha­pur, the lead au­thor. “It seems that la­tent TB bac­terium al­ters the en­vi­ron­ment in an ovary, lead­ing to poor egg qual­ity.”

To es­ti­mate the egg re­serve, re­searchers mea­sured an­tim­ul­le­rian hor­mone (AMH) lev­els, which in­di­cate a woman’s egg re­serve. The hor­mone is pro­duced by the ovaries. Women with TB had 30% lower AMH as com­pared to women with­out the in­fec­tion, the study re­vealed.

More­over, the re­sults showed La­tent gen­i­tal tu­ber­cu­lo­sis refers to the pres­ence of My­cobac­terium tu­ber­cu­lo­sis in the gen­i­tal tract

Gen­i­tal tu­ber­cu­lo­sis causes in­fer­til­ity in women and of­ten ex­ists with­out ap­par­ent signs and symp­toms

It af­fects fal­lop­ian tubes fol­lowed by en­dometrium of the uterus and ovaries

De­tec­tion rate of gen­i­tal tu­ber­cu­lo­sis is as low as 7% to 19% that women who un­der­went stan­dard anti-tb treat­ment had sig­nif­i­cant im­prove­ment in preg­nancy rates. Chances of preg­nancy im­proved to 51.6% for women who un­der­went anti TB treat­ment com­pared to 40.5% who didn’t re­ceive the treat­ment. How­ever, there was no im­prove­ment in the egg count.

Deepak Modi, sci­en­tist at PCR tests can con­firm pres­ence of TB bac­terium in gen­i­tals Gen­i­tal tu­ber­cu­lo­sis is di­ag­nosed in 35% to 50% in­fer­tile women in In­dia

Women with TB had 30% lower anti-mul­le­rian hor­mone (AMH) lev­els as com­pared to women with­out the in­fec­tion

Pa­tients who un­der­went stan­dard anti-tb treat­ment had sig­nif­i­cant im­prove­ment in preg­nancy rates

Chances im­proved to 51.6% for women who un­der­went anti TB treat­ment as com­pared to 40.5% who didn’t re­ceive the

treat­ment Na­tional In­sti­tute of Re­search in Re­pro­duc­tive Health, In­dian Coun­cil of Med­i­cal Re­search (ICMR), Parel, said the study sug­gests that many women with la­tent gen­i­tal TB, may be able to con­ceive with­out IVF.

“If la­tent TB is di­ag­nosed and treated, some women may con­ceive with their own eggs and may not need IVF or egg dona­tion,”

MA­JOR FIND­INGS

Af­ter re­ceiv­ing treat­ment for TB, the em­bryo im­plan­ta­tion rates im­proved

Suc­cess of rate in­creased by 27% in pa­tients treated with anti-tb drugs as com­pared to 17% who weren’t treated. DEEPAK MODI, sci­en­tist at Na­tional In­sti­tute of Re­search in Re­pro­duc­tive Health, In­dian Coun­cil of Med­i­cal Re­search (ICMR), Parel

he added.

Modi said there is a need to im­prove de­tec­tion rates of la­tent gen­i­tal TB, so that women can be put on treat­ment at the ear­li­est.

Ac­tive gen­i­tal TB is the most com­mon form of ex­tra pul­monary TB, yet has de­tec­tion rate as low as 7% to 19%, ac­cord­ing to pre­vi­ous stud­ies, the au­thors said.

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