Will I be able to conceive with endometrial tuberculosis?
Q: I have been detected with endometrial tuberculosis after a biopsy was done and a PCR test. Also, I have been detected with chronic cervicitis and non secretory endometrium. I am on anti-TB medicine for last one week. Please tell me whether I will be able to conceive after this has been treated? I have read that tubes are affected first before it spreads to the endometrium. I am 30 years old, married for 5 years and want a child. Please help.
A:From the results it seems you have early stage endometrial TB as the pathology report does not show any evidence of TB and the diagnosis is through PCR test. That is good. You must have ATT in standard dosages, i.e. 2 months of intensive phase of treatment with 4 drugs and at least another 7 months with 3 drugs (maintenance phase). You should be monitored carefully for adverse effects of the drugs. If the drugs are not taken in proper way you can develop resistance to the first line therapy of drugs and that will be a big problem for you. Treatment with second line drugs is difficult and the TB may spread to other parts of your body. I wonder whether or not you suffered from TB earlier (of say the lungs, abdomen or lymph nodes). If not, you must ensure that your husband’s semen is tested for TB by PCR. Sometimes the husband’s infection is passed on to wife, which many gynaecologists forget to test. Regarding your prognosis: 1. Majority of times, i.e. in close to 100% of cases of TB endometrium, the tubes are also affected. After full ATT, your tubal patency test should be done (if endometrium is negative for TB PCR) In fact, after 4- 6 months of ATT your endometrium should be retested for TB PCR to see you are responding to ATT. However, patent tubes do not guarantee proper functioning of tubes in TB. 2. If you do not conceive for 6 months following ATT despite endometrium being negative for TB PCR and tubes being patent, you will have to undergo a hysteroscopy (examination of the cavity of your uterus with an endoscope), and see whether or not you can conceive with IVF-ET (test tube baby). 3. I have 3 cases under my care who conceived spontaneously after ATT (in fact 1 woman conceived while on treatment and had a healthy baby boy). So do not lose hope - take 1 thing at a time. You should aim to complete your treatment successfully first. Besides, remember you always have the option of adopting a baby. Believe me, this will give you lot of fulfillment, and give a child the security and love of a home. Besides, this does not cost money and results are guaranteed. On the other hand IVF-ET has a success rate of around 30% even in the best centres.