Tjahyadi Dian, Tjandraprawira Kevin Dominique
Department of Obstetrics and Gynaecology, Faculty of Medicine, Dr. Hasan Sadikin General Hospital, Universitas Padjadjaran, Bandung, Indonesia.
Bandung Fertility Center, Limijati Women and Children Hospital, Bandung, Indonesia.
Ann Med Surg (Lond). 2022 Aug 19;81:104438. doi: 10.1016/j.amsu.2022.104438. eCollection 2022 Sep.
Genital tuberculosis (TB) exerts significant damage in the reproductive organs, particularly the Fallopian tubes and endometrium. Infertility is one of the most common presenting causes, often subsequently requiring assisted reproductive technology (ART). However, we have not had many experiences with genital TB despite being a country endemic for TB. This case series highlights the challenges we face and the solutions we wish we had.
In this case series, we recruited 7 patients undergoing (IVF) treatment previously diagnosed with TB between January 01, 2014 and June 30, 2021. Patients were recruited at the beginning of their IVF treatments. Of 7 patients, 2 patients (28.6%) achieved live birth. 5 patients (71.4%) failed to conceive. All patients had good and/or excellent quality embryos upon transfer but only 2/7 managed to conceive and delivered.
Genital TB is often silent and only encountered during workup for infertility. Genital TB often produces extensive damage on the linings of the endometrium and Fallopian tubes, accounting for the recurrent implantation failures associated with the disease. Whilst antitubercular treatment may improve the prognosis, many women still fail to conceive.
Genital tuberculosis remains a significant issue in infertility. Cases are often silent and management is often delayed. IVF is often required due to the longstanding damage caused beforehand yet prognosis may remain poor.
生殖器结核对生殖器官，尤其是输卵管和子宫内膜造成严重损害。不孕是最常见的就诊原因之一，通常随后需要辅助生殖技术（ART）。然而，尽管我国是结核病流行国家，但我们在生殖器结核方面的经验并不多。本病例系列突出了我们面临的挑战以及我们希望拥有的解决方案。
在本病例系列中，我们招募了7例在2014年1月1日至2021年6月30日期间接受体外受精（IVF）治疗且先前被诊断为结核病的患者。患者在IVF治疗开始时被招募。7例患者中，2例（28.6%）成功分娩活婴。5例（71.4%）未能受孕。所有患者在移植时胚胎质量良好和/或优秀，但只有2/7成功受孕并分娩。
生殖器结核通常没有症状，仅在不孕检查时才被发现。生殖器结核常对子宫内膜和输卵管内膜造成广泛损害，这是该疾病导致反复种植失败的原因。虽然抗结核治疗可能改善预后，但许多女性仍无法受孕。
生殖器结核仍然是不孕领域的一个重要问题。病例通常没有症状，治疗往往延迟。由于先前造成的长期损害，通常需要进行IVF，但预后可能仍然很差。
