Liu Kun, Zhang Xuehong, Ma Xiaoling, Jia Xueling, Zhao Xiaodong, Yang Xia, Zhang Yufeng
Reproductive Medicine Centre, The First Hospital of Lanzhou University, Lanzhou, 730030, Gansu, China.
Open Med (Wars). 2020 Nov 9;15(1):1083-1086. doi: 10.1515/med-2020-0236. eCollection 2020.
Although female genital tuberculosis may lead to infertility, pregnancy is still possible, especially through fertilization (IVF). In this eventuality, even latent tuberculosis (TB) infection is prone to reactivate. Because some of the symptoms of TB overlap with those of pregnancy, diagnosis and treatment may be delayed. We report the case of a 30-year-old infertile woman with repeated genital tuberculosis (GTB) who underwent two laparoscopic surgeries and anti-TB treatments. The woman conceived through IVF and, unfortunately, a cervical pregnancy was diagnosed, together with a third recurrence of GTB. When the condition became stable after anti-TB treatment, the pregnancy was terminated using oral mifepristone in combination with an ultrasound-guided local injection of methotrexate. The gestational sac was expelled 4 days later with minimal blood loss. In view of the reciprocal influence and interconnection between IVF, pregnancy, and TB, we conducted a literature review to provide valuable information for early diagnosis and treatment, as well as for routine screening before IVF of TB in infertile patients.
尽管女性生殖器结核可能导致不孕，但仍有可能怀孕，尤其是通过体外受精（IVF）。在这种情况下，即使是潜伏性结核（TB）感染也容易复发。由于结核病的一些症状与妊娠症状重叠，诊断和治疗可能会延迟。我们报告了一例30岁的不孕女性，她患有复发性生殖器结核（GTB），接受了两次腹腔镜手术和抗结核治疗。该女性通过IVF受孕，不幸的是，诊断为宫颈妊娠，同时GTB第三次复发。抗结核治疗后病情稳定后，使用口服米非司酮联合超声引导下局部注射甲氨蝶呤终止妊娠。4天后妊娠囊排出，失血极少。鉴于IVF、妊娠和结核之间的相互影响和相互联系，我们进行了文献综述，以提供有关早期诊断和治疗以及不孕患者IVF前结核常规筛查的有价值信息。
