Role of latent female genital tuberculosis in recurrent early pregnancy loss: A retrospective analysis

Background: Latent Female Genital tuberculosis (FGTB) or tubercular infestationis prevalent in Southeast Asia and even the presence of tubercular bacilli in thegenital tract is becoming an important factor for reproductive failure. An immatureendometrium becomes non-receptive, preventing implantation or rejection ofimplanted embryo in early months, resulting in recurrent pregnancy loss (RPL) inassociation with other factors.Objective: To detect the underlying causes of RPL in addition to the proven causes likeuterine cavity defects, thrombophilia, chromosomal abnormalities, etc.Materials and Methods: 317 women with RPL, enrolled over a period of 60 months( January 2014 to December 2018) conducted at Calcutta Fertility Mission in the presentstudy. They were grouped in A, B, and C and undergone routine tests for the same alongwith the PCR test with an endometrial aspirate.Results: Patients with only latent FGTB (Group A), patients with FGTB and associatedfactors (Group B), and patients with other causes of RPL (other than latent FGTB) (GroupC) were34.4%, 42.3%, and 23.3% respectively. About 29.36%, 47.01%, and 21.62%ofthe patients had achieved pregnancy in Group A, B, and C, respectively. The rate ofmiscarriage was high in both Groups A and B, affected with latent FGTB, and live-birthwas higher (75%) in Group C that did not have tubercular involvement of the genitaltract.Conclusion: The tubercular infestation or latent FGTB as per our study appears to bea very important cause of RPL in patients with recurrent unexplained miscarriage. Itshould be treated adequately at an early stage to prevent permanent damage to pelvicorgans and restore reproductive health in women.

کلیدواژه ها:

Female genital tuberculosis ، Recurrent pregnancy loss ، Endometrium ، Implantation