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  • Title: Second-look hysteroscopy after antitubercular treatment in infertile women with genital tuberculosis undergoing in vitro fertilization.
    Author: Bahadur A, Malhotra N, Mittal S, Singh N, Gurunath S.
    Journal: Int J Gynaecol Obstet; 2010 Feb; 108(2):128-31. PubMed ID: 19892339.
    Abstract:
    OBJECTIVES: To assess the efficacy of antitubercular treatment on the uterine cavity in infertile women diagnosed with genital tuberculosis using second-look hysteroscopy. METHODS: A total of 70 women with genital tuberculosis who underwent second-look hysteroscopy were enrolled in the study. They were started on antitubercular drugs and followed up after 6 months of therapy with second-look hysteroscopy. McNemar's chi(2) test was used to compare the hysteroscopy findings before and after antitubercular treatment. RESULTS: Antitubercular treatment improved hysteroscopy findings in women with thin or flimsy adhesions (grade I), singular dense adhesions (grade II), and occluding adhesions at the internal os (grade IIa) (P<0.01). Patients with extensive adhesions, extensive endometrial scarring, fibrosis, and a tubular cavity showed no improvement after antitubercular treatment. Mean endometrial thickness of the 70 patients on day 21 prior to starting drug therapy was 6.8mm, which increased to 8.1mm after 6 months of treatment. CONCLUSION: Considering the exorbitant cost of assisted reproductive technology in low-resource countries, it is necessary to consider reassessment of the uterine cavity prior to beginning such treatment.
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