On a global scale, tuberculosis (TB) has a devastating impact in developing nations with 13 countries accounting for nearly 75% of all cases.1 TB exists in two forms: pulmonary tuberculosis and extrapulmonary tuberculosis. Genital TB is one form of extrapulmonary TB and is not uncommon, particularly in communities where pulmonary TB is prevalent, but it is rare in Western societies. In India, genital tuberculosis is rapidly increasing amongst women.
Female genital tuberculosis is a rampant disease which is also growing as a major health issue that leads to infertility. According to various medical researchers, tuberculosis is a root cause of infection which results in infertility among 25-30% of women in India. Genital tuberculosis is a prominent factor for infertility not only in females but also in males. What is Genital Tuberculosis?
‘Genital TB is that form of the disease that predominantly affects the female genital organs – ovaries, fallopian tubes, uterus, cervix and vagina – or the surrounding lymph nodes in the pelvis.’
Usually, Tuberculosis or TB is a deadly infectious disease which initially affects lungs. It can further cause secondary infections in the genital tract, vagina, pelvic area, kidneys, spine and brain.
When the bacteria attack the genital tract, it causes genital tuberculosis which is also known as pelvic TB which mostly affects women during childbearing period and is usually diagnosed during infertility workup.
One of the major issues is that the disease is easier to detect if it affects the lungs primarily, but if the bacteria directly attacks the genital organs, it is difficult to detect at later stages and reduces the chances of conception among women. How Does it Occur? Tuberculosis is a highly infectious and communicable disease which can spread easily through an infected person.
According to Dr. Priti Gupta, Consultant Fertility & IVF, First Step IVF Clinic "The infection is likely to spread through inhalation or breathing. If you are physically close to an infected person, than you are at high risk of acquiring tuberculosis because such infection can easily spread through air. At initial point, tuberculosis primarily affects the lungs then later, the bacteria travels to the other parts of the body through blood. She further added that people with low immunity are the frequent victims of TB." Symptoms At initial stage, genital TB doesn't show any symptoms but after seven or eight months a person can account the following symptoms: Vaginal discharge, Severe pain in lower abdomen, Irregular menstruation, Amenorrhea, Heavy bleeding.
How does it cause infertility? Tuberculosis has the ability to severely damage the fallopian tubes if not treated at the initial stage which can further lead to serious health complications. Doctors say that 30% of women with any type of tuberculosis tend to develop genital TB, out of which, 5-10% evolves hydro salpingitis in which the water fills up into the tube, resulting in infertility. Dr. Priti Gupta says, "The TB bacteria mainly affect the fallopian tubes by blocking it which leads to inadequate periods and infertility. In some cases, periods may entirely stop as the uterine lining gets deeply affected."
She further added that "Genital TB has less effect on vagina, vulva, and ovaries as compared to the fallopian tubes". Therefore, it is very important to treat the disease quickly otherwise the chances of conceiving in the future may, unfortunately, become next to nil. Tests and Treatment A disease like genital TB can lead to deformity of fallopian tube structures and adverse pain.
But as per Dr. Priti Gupta, "As genital tuberculosis is asymptomatic; there is no specific test to detect the disease. There are combined tests which are used to investigate whether a person is suffering from genital TB. Endometrial biopsy and laparoscopy can be used to check whether the fallopian tube is affected or not. Other tests like tuberculin test or blood test can be done to detect tuberculosis". It is essential to get tested and treated at the right time to avoid any serious health complications in the future.