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Does positive TB IGM is related to my endometrium thickness and conceiving ?

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Practicing since : 1983
Answered : 979 Questions
Hello Doctor,
I am 24 yrs old female. My wieght is 51 Kgs. and my height is 5.3 Feets. Me and my husband are trying to concive from last 1 year but no results. In my initial blood test my TB IGM came positive but later Mountox test and Avd. PCR came negative. Also a test done for TB IGM by taking my endometrium sample came negative.Does that mean that there no chances for me to have TB IGM. Also my endometrium thickness comes out to be less then 7 in most of my follicle studies. Does the positive TB IGM has any relation with my endometrium thickness? i also underwent HSG test and my doctor told me that my left tube is patent but she has doubt with my right tube. According to her, I have a tilted uterus so that might be the reason for it. I went for 1 IUI in my previous cycle.
Thanks a lot in advance.
Posted Thu, 12 Apr 2012 in Infertility Problem
Answered by Dr. Minoo Bhagia 2 hours later

Thanks for posting the query.

IgM antibodies indicate recent infection.

To confirm the diagnosis, PCR of the fluid from pouch of XXXXXXX and histopathology of endometrium are more accurate methods.

Regarding endometrial thickness, in proliferative phase it is 4-14 mm and after ovulation means in secretory phase it is 15-28 mm.

You have mentioned 7mm in follicular studies means it is in midcycle which is less.

Were there any mature follicles and what are their size?

I think you need to get completely evaluated to confirm the diagnosis and for that investigations like ESR, endometrial biopsy and its histopathology, Trans Vaginal Sonography for follicles and diagnostic laparoscopy to see the patency of tubes.

For endometrial thickness start taking dydrogesterone within minimum levels daily in secretory phase.

If it comes out positive for TB then take the complete treatment for it.

If there are no mature follicles then take tablet letrozole daily from 3rd to 7th day of cycle after discussing with your doctor and go for follicular studies.

Hope this answers your query. In case of any doubts, I am available for the follow ups.

Wish you good health.

Take care
Above answer was peer-reviewed by
Follow-up: Does positive TB IGM is related to my endometrium thickness and conceiving ? 15 hours later
Thank you for the answer Doctor.

My Histropathology Report is as follows:

Specimen : Endometrium
Clinical notes : LMP-28day
Gross Examination : Received dark brown soft tissue pieces measuring 1.5 cms in all.
Microscopic Examination : section shows fragmented endometrial glands lined by columnae epithelium with dissolution in stroma.There is evidence of haemorrhage, necrosis & neutrophilic exudate. No dysplastic/ malignant changes could be observed. Findings are suggestive of anovulatory cycle.
Diagnosis : Anovulatory cycle.

My Follicle sizes for yesterday in this cycle are:
right ovary : 25x25, 18x15, 15x11, 14x11
left ovary 14x14, 14x12
endometrium : 6

Follicle size of my last cycle before ovulation was:
right:21x20, 20x20,19x17,13x11
endometrium: 8

i am already taking lutacare which has progesterone. I've taken Dupastone also in my previous 2 cycles.
I don't understand the reason why my endometrium is so weak.
My doctor did IUI in my previous cycle. She did IUI 24hrs and 48hrs after HCG shot.
I dont know if it was correct timing to do iui.

My ESR(after 1 hour) came 10 mm.
Mycrobacterium TB(PCR) came negative.
I am bit worried and afraid of going for Laproscopy right now.
I would really appreciate if can give me some more suggestion after reading the above points.

Thank you so much.
Answered by Dr. Minoo Bhagia 6 hours later

Thanks for writing again,

You can try injection FSH, pure form like gonal F 75 IU ON 3rd, 5th and 7th day of the menstrual cycle under doctor's supervision and then go for the follicular studies on 11th -13th day.

As soon as you see mature follicle size upto 20mm you can go for injection hCG, pure form 5000 IU, it comes in various names like Corion, Pergonal etc.

Then see under ultrasound whether the follicle has ruptured or not, you will see some free fluid in pouch of XXXXXXX

May i know if have you ever gone for FSH, LH levels in the blood ?

For better quality of ova you can start taking ovacare forte one combipack twice daily.

I hope you are not having PCOD.

If your cycles are anovulatory then I do not think that IUI will hellp in your case.

Susten gel or Susten VT are used for progesterone deficiency.

I hope you get pregnant very soon.

Wishing you good luck.

Above answer was peer-reviewed by
Follow-up: Does positive TB IGM is related to my endometrium thickness and conceiving ? 4 hours later
Thanks Doctor. I don't know about fsh and LH surge. I don't think my doctor has tested that and she has not even tested for PCOD. In my follicle studies I always ovulate, then why does the report states that my cycle is anovulatory.
Also can't iui be successful after taking clomid and HCG Shot 5000 unit.

I will talk to my doctor about FSH. Thank you so much I didn't know about it.
Also today when I went for follicle they were :
right ovary: 28x25, 18x15, 15x13, 14x11
left: 14x14, 14x12
endometrium: 8 triple time
I wonder why one of my follicle is 28x25 in size?
I took HCG Shot day before yesterday in midnight.

I did ask this previously...does my weak endometrium can have any direct relation with my positive TB IGM blood test? Even though later all my tests came negative.
Thank you so much for all the help that I so much wanted.

Answered by Dr. Minoo Bhagia 8 hours later

Follicle size upto 20mm is pretty good.
You should get your progesterone levels done in the post ovulatory period.
They are labelling your cycle as an anovulatory cycle due to deficient luteal phase.
One positive reading of IgM which becomes negative later on is not conclusive of tuberculosis.
In my opinion you should get following tests done :
Serum FSH on day 3rd of the cycle
LH on day 13-15
Oestradiol in preovulatory phase
Progesterone in post ovulatory phase
DHEA-S and

Endometrial biopsy and its histopathology to confirm the tuberculosis.
AFB culture and menstrual blood culture.
PCR and
TB gold test
One test can not be 100%specific and 100% sensitive.

Do not forget to use progesterone supports like dydrogesterone , micronised progesterone gels and vaginal effervescent tablets.
Avoid stress
Regular exercises and nutritional modifications play important role in the treatment of infertility.
God bless you
I am always there for your further queries

Above answer was peer-reviewed by
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