Tuberculous infertility and in vitro fertilization

OBJECTIVES: Our purpose was to assess the outcome of in vitro fertlization and embryo transfer in tuberculous infertility and to study the factors associated with success or failure of treatment. STUDY DESIGN: Ten patients with tuberuclous infertility underwent 22 cycles of in vitro fertilization and 9 cryopreserved-thawed embryo transfers at Bourn Hall Clinic. All patients underwent endometrial assessment by ultrasonography. Four patients had preliminary hysteroscopy, endometrial biopsy, and Doppler uterine blood flow studies. RESULTS: Six clinical pregnancies resulted in three live births in three patients and one current pregnancy in a fourth patient. There was one ectopic pregnancy and one twin pregnancy that aborted spontaneously at 14 weeks. The patients who had trophic endometrium achieved pregnancy at a rate of 42.9% (six of 14) (per embryo transfer) compared with 0% (none of 14) if the endometrium was atrophic. CONCLUSION: In vitro fertilization and embryo transfer offers the only realistic treatment for tuberculous infertility. Preliminary assessment of the endometrium is helpful in assessing prognoses in these cases.