Genital tuberculosis (TB) is a major cause of tubal infertility. Only two per cent of women with genital TB have live births. It is usually asymptomatic, and thus needs higher degree of suspicion so that proper diagnosis can be made and standard treatment provided as early as possible.
Tuberculosis affecting the Fallopian tubes usually leads to formation of typical tuberculous nodules, which can compress and occlude the Fallopian tube. The tuberculous process also destroys the wall of the affected part of the tube itself. These changes can lead to tubal obstruction that prevent the egg to reach the uterus, resulting in tubal infertility. This process usually does not show any clear symptoms, and thus can go on for a long time. Only some subtle changes, like pelvic pain or menstrual cycle irregularities, can suggest a problem with the Fallopian tubes.
Genital TB is responsible for infertility in 5-10 per cent of women. In Australia, 1 per cent infertility in women is attributed to genital TB but in India, 19 per cent infertility in women is attributed to genital TB. Also the impact of genital TB is more severe on lives of women because mostly genital TB impacts women of age group 15-35 years. Only 10% of genital TB in women is post-menopausal. The solution lies in early case detection and providing standard treatment for genital TB.
Sadly if women with genital TB are diagnosed late, the infertility risk and other harm done to their tissue are likely to be much more severe.