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Unable to conceive. PCR test for menstrual blood done, mycobacterial detected. Infertility treatment?

Hi, I am 35 year old woman and recently gone through menstural blood pcr test and mycobacterial have been detected. My doctor said, I will not get pregnant because of this situation and suggested some medication for 3 months. and also said if I wont conceive in these 3 months, she needs to do some tube test. I am really scared that I will never get pregnant. I desperately want a baby. Can you share your thoughts on the above? Thanks
Asked On : Thu, 4 Oct 2012
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OBGYN 's  Response
hello there

Menstrual blood PCR positive for mycobacterium suggests endometrial tuberculosis.

In the woman, it cause tuberculous endomteritis ( infection of the uterus) and salpingitis ( infection of the tubes). This infection can often be silent, and may not cause any symptoms or signs.

Once the histologic diagnosis of TB endometritis has been made(like in your case), then treatment with antitubercular medicine must be started to prevent further progression of the disease. However, usually with TB endometritis, infection of the fallopian tubes also occurs and the damage caused to the tubes ( TB salpingitis) is irreversible. Infection of tubes might result in irreversible tubal infertility, and the only treatment option available then to conceive would be IVF. In the past some doctors would try to do surgery to repair the tubes, but this is futile surgery, because the tubes never work properly once they have been infected. Tubes which have been severely damaged may form a hydrosalpinx( dilated tubes with infected fluid), and may need to be removed surgically, prior to IVF, if they are very large.

Although antitubercular chemotherapy is the mainstay of treatment, surgery may be indicated where medical therapy has failed to resolve symptoms and in presence of a persistent pelvic mass.

So i suggest for now you continue with your antitubercular drugs which has to be taken minimum for 6 months. At present you should not undergo any tube test as in presence of a genital infection, any kind of tube test is contraindicated as it might flare up the infection. Since your diagnosis of TB has been made , theres no use getting a tube test now. ONLY after you complete your treatment and get repeat PCR menstrual blood negative for mycobacterial infection, then you can go for tube test if you dont conceive.

After treatment for genital TB, the conception rate is low (19.2%) with a livebirth rate of 7.2%.There is also an increase in ectopic pregnancy and miscarriage rates (when endometrial scarring occurs after infection). In vitro fertilisation should therefore be offered to you if you fail to conceive spontaneously.

So dont worry, there are options to conceive. Take your folic acid tab simultaneously which increases chances to conceive and improves pregnancy outcome.
Answered: Thu, 4 Oct 2012
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