Can I conceive after being treated for latent tuberculosis?
Q: I am a 30 years old woman planning a baby for the last one year but in vain. My husband’s and my tests for fertility were all normal. Recently, I got an interferon gamma release assay (IGRA) and tested positive for latent tuberculosis (TB). The doctor asked me to get a chest X-ray, a transvaginal scan and other ultrasounds done, which were all normal. Then she suggested an endometrial biopsy (EB), which I was not willing to undergo and she said that whether or not I get this biopsy done, she would put me on medication. I have also got my fallopian tube imaging done and it was all clear and normal. I have started medication for latent TB for 6 months. During the treatment I was not supposed to try for conception for 2-3 months. The doctor prescribed Mycobutol for 6 months, RcineX for 6 months, Pzide for 2 months and multivitamins. I have finished one month course of these medicines and also got a liver test done to see if the medicines were not adversely affecting the liver and the test results were fine and within the reference range. Can latent TB be a cause of infertility and will this treatment help? Also, after the two-month course of Pzide, should I go for endometrium biopsy or IGRA? Am I taking the right treatment? Please advise.
A:I agree with your gynaecologist that you should have got the EB done to test for genital TB. In fact, I am surprised you got the tube test done without the EB!! If the EB was positive for TB by histopathology or AFB culture, it would indicate that genital infection is active and chances of intrauterine conception would be far less than if only the PCR for Myc. TB was positive. If only the PCR was positive, chances of spontaneous intrauterine conception are very high. Also, if your EB tested positive for TB by histopathology, culture or PCR, you should get your husband’s semen tested for Myc. TB by PCR and culture. In any case, if his semen analysis is normal, it is unlikely that he has passed on the TB to you. Now that you have already started the treatment since 1 month, the EB may not show up the TB (if it was very early). Anyway, it is good to get it done. If positive, you should repeat it after a minimum of 4 months of treatment. Also, if the histopathology report, or culture and / or PCR for TB is positive (on EB), I would recommend at least 9 months of treatment.