Zhang Xiaoling, Zhuxiao Ren, Xu Fang, Zhang Qi, Yang Haoming, Chen Liang, Liu Fenghua, Yang Jie
1 Department of Neonatology, Guangdong Women and Children Hospital, Guangzhou, Guangdong, 510010, China.
2 Department of Clinical Genetic center, Guangdong Women and Children Hospital, Guangzhou, Guangdong, 510010, China.
J Int Med Res. 2018 Dec;46(12):5316-5321. doi: 10.1177/0300060518808179. Epub 2018 Nov 19.
Congenital tuberculosis (CTB) after in vitro fertilization (IVF) is a major new problem in developing countries. Only 16 cases of CTB after IVF have been reported, and no tuberculosis (TB) tests were performed before IVF in these cases. However, on the basis of data in the literature and from the World Health Organization, the incidence of CTB has been substantially underestimated. We describe two cases of CTB after IVF in detail in our center and provide new insight into the important issue of controlling TB vertical transmission in developing countries. Performing an early diagnosis of CTB, mostly based on evidence of maternal infection and a high index of clinical suspicion, is a challenge. However, most mothers have no symptoms of TB infection during prepartum, and infertility may be the only symptom. Infertility caused by genital TB is common in countries with a high TB burden, and IVF is considered to be an effective treatment to improve their fertility. Therefore, this may lead to more CTB cases without thorough TB tests before IVF. We suggest that thorough TB tests should be conducted in infertile women before IVF to prevent CTB.
体外受精（IVF）后发生的先天性结核病（CTB）是发展中国家出现的一个重大新问题。目前仅报告了16例IVF后发生CTB的病例，且这些病例在IVF前均未进行结核病（TB）检测。然而，根据文献数据和世界卫生组织的数据，CTB的发病率被严重低估了。我们在本中心详细描述了2例IVF后发生CTB的病例，并为发展中国家控制TB垂直传播这一重要问题提供了新的见解。早期诊断CTB具有挑战性，主要依据是母体感染证据和较高的临床怀疑指数。然而，大多数母亲在产前没有TB感染症状，不孕可能是唯一症状。在TB负担较高的国家，生殖器结核导致的不孕很常见，IVF被认为是改善其生育能力的有效治疗方法。因此，这可能导致更多IVF前未进行全面TB检测的CTB病例。我们建议在IVF前对不孕女性进行全面的TB检测，以预防CTB。
