Genital tuberculosis and its impact on male and female infertility | Health

Tuberculosis is infectious especially pulmonary tuberculosis which is primary site followed by genital organs which are secondary site and for the uninitiated, TB spreads by nasal route to lungs then spreads by blood to any part of body – brain, skin, glands, genital organs etc when the immunity is reduced but few know that it can lower the sperm count in men and is a frequent cause of infertility among women too. Genital tuberculosis is an infection caused by Mycobacterium tuberculosis, which affects the female genital organs and it can cause endometrial involvement and lead to infertility in women but female genital tuberculosis is much less common than male genital tuberculosis.

In an interview with HT Lifestyle, Dr Suparna Bhattacharya, Fertility Consultant at Nova IVF Fertility East at Kolkata’s Uttam Kumar Sarani, explained, “The reproductive organs may suffer irreparable harm if untreated. Prompt therapy is highly beneficial, and many couples who receive it promptly go on to have healthy spontaneous pregnancies. Male reproductive organs (like testis, epididymis, vas deferens, seminal vesicles, prostrate) are infected by genital TB, which usually results in distortion and obstruction of the normal anatomy preventing sperm from being ejaculated resulting in azoospermia. Epididymitis, a swelling of the epididymis (tube near the testicles), can result from it. Beading can also develop on the spermatic cord, which supports the testicles in the scrotum.”

She elaborated, “The conception is hampered by GTB in females, which mostly affects the fallopian tubes, uterus and occasionally the ovaries.
Fallopian tubes may become damaged by tuberculosis and obstruct the fertilized egg’s entry into the uterus or possibly prevent fertilization altogether. 90% of women who have genital TB have damaged fallopian tubes. Symptoms of uterine TB – irregular menstruation, pelvic pain, inadequate endometrial lining resulting in infertility and persistent infection can potentially harm the uterine cavity causing synechia and result in amenorrhea (complete cessation of menses). A disorder known as “Premature Ovarian Failure” may develop when one or both ovaries being affected. Before the age of 40, the ovaries begin to malfunction, generate less oestrogen and may stop producing eggs. If the eggs are released, they might not be of good quality to be fertilised.”

Talking about genital tuberculosis and its impact on male and female infertility, Dr DS Sowjanya, Senior Pulmonologist at Kamineni Hospitals in Hyderabad, said, “The infection usually starts in the fallopian tubes and spreads to other parts of the female reproductive tract, such as the uterus, ovaries, cervix and vagina. Genital tuberculosis (TB) is an active genitourinary form of TB and is caused by the mycobacterium tuberculosis. It is a primary infection of the female genital organs, and can cause bilateral fallopian tube infection, as well as infection of the uterine myometrium and endometrium. Infected women often experience pain in their abdomen that worsens with movement or sexual intercourse. Symptoms also include fever, weight loss, night sweats and irregular periods or heavy bleeding. In some cases, it may lead to infertility due to blockage of the fallopian tubes or scarring of the uterus or ovaries.”

The health expert revealed, “If not treated early, genital TB can spread from the genital tract to other parts of a woman’s body such as her lungs (pulmonary TB). This type of TB can be more difficult to treat than other types since it involves multiple organ systems. Genital tuberculosis affects both male and female reproductive organs, however its impacts are more severe in women due to its ability to spread throughout the entire genital tract including into her uterus, ovaries and vagina. Mycobacterium tuberculosis is the major cause of genital tuberculosis and is one of the most common causes of high tuberculosis prevalence in many parts of the world. Asymptomatic nature and diagnostic challenges associated with genital tb makes it difficult to diagnose and treat, leading to severe consequences for female patients, including infertility. Symptoms can include abdominal pain, irregular periods, discharge from vagina and painful intercourse.”

Highlighting that there are tests which are used to investigate TB, Dr Suparna Bhattacharya concluded, “It can be effectively treated with antibiotics given by a medical professional. It is advised that anyone who exhibits symptoms of genital TB undergo a test for the condition. With good antitubercular therapy women can be helped to try naturally to conceive or try through ART.”