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How is the tuberculosis of the reproductive organs diagnosed?

Q: I am 36 years old and unable to conceive. Along with other tests, I also underwent a test for tuberculosis when IgG was 192.0 units and IgM was 1.20. Doctor prescribed me medicines defining it as a possibility of tuberculosis. I decided to take a second opinion and went to another doctor who said that she won't rely on this report. She said that she will look into this and other problems of mild endometriosis, fibroids and dilated distal half of left fallopian tube after laparoscopy and then decide. Laparoscopy was done after 3 days, no tuberculosis was found and other problems were solved during laparoscopy. One sitting of IUI was done, which failed and I didn't go for another one. Now after 2 years, I am still unable to conceive. Doctors have told me that endometriosis can't be treated through laproscopy and tuberculosis of uterus can't be detected through laparoscopy. Instead they said that, if there was tuberculosis at the time of surgery, it would have increased by now. I was prescribed another test for tuberculosis. My TSH level is 10.23uIU/mL (normal range 0.27 to 4.2uIU/mL). I am taking Thyronorm 50 mg. Is it enough?

A:Only way to confirm tuberculosis of reproductive organs in women is by Real-time PCR. It can be done on endometrial biopsy or fluid from pouch of Douglas. However, very few labs (if any) have Real time PCR assay. Real time PCR is highly sensitive than the conventional PCR. Therefore one should be very careful in ordering this test. Many labs undertake conventional PCR assay for the diagnosis of tuberculosis and other infections without even including proper controls.

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