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Will tube removal and tuberculosis lead to infertility?

Wednesday, 19 May 2010
Answered by: Dr Niraj Krishnamurthy
Obstetrician and Gynaecologist, London
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Q. I am a 27 years old female, who had ectopic pregnancy in left tube, which was operated by laparoscopic surgery four months back. During surgery, left tubal abortion was done. While examining tissue of the tube, tuberculosis (TB) in my fallopian tube was found. Then, I was kept on the treatment of AKT-4 anti TB medicine and medication will continue up to six months. After the surgery, my Beta HCG test was monitored every week and has declined for two consecutive weeks. But in 3rd week, it started increasing. After a month, ultrasonography was done and it was found that some pregnancy still persisting in my left tube. Then, I was again kept on medication of methotrexate for four days. Finally, after a couple of days, the doctor removed my left fallopian tube. Will tube removal and tuberculosis lead to infertility? How can tuberculosis in my fallopian tube be treated? My TSH level is 3.75.

A.  When you have a tube removed for ectopic pregnancy, the possibility of you having a successful (intrauterine) pregnancy is approximately 55%. I do not think there are any studies to quote the figure in your kind of clinical scenario i.e. with pelvic TB affecting the remaining tube. There is also unfortunately an increased risk of having subsequent ectopic pregnancy in view of two risk factors (previous ectopic pregnancy and TB). However, it is still possible to achieve a successful pregnancy despite having these risk factors. The way TB will affect your reproductive performance is by damaging the way your tube functions. Curing TB does not necessarily always revert those changes in the tube.

A.  When you have a tube removed for ectopic pregnancy, the possibility of you having a successful (intrauterine) pregnancy is approximately 55%. I do not think there are any studies to quote the figure in your kind of clinical scenario i.e. with pelvic TB affecting the remaining tube. There is also unfortunately an increased risk of having subsequent ectopic pregnancy in view of two risk factors (previous ectopic pregnancy and TB). However, it is still possible to achieve a successful pregnancy despite having these risk factors. The way TB will affect your reproductive performance is by damaging the way your tube functions. Curing TB does not necessarily always revert those changes in the tube.

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