Second-look hysteroscopy after antitubercular treatment in infertile women with genital tuberculosis undergoing in vitro fertilization
Received 2 June 2009; received in revised form 6 August 2009; accepted 23 September 2009. published online 05 November 2009.
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 6months of therapy with second-look hysteroscopy. McNemar's χ2 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 6months 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.
Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
Corresponding author. Room No. 8, Ladies Hostel 9, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 10029, India. Tel.: +91 9313326955; fax: +91 11 26588449.
ABSTRACT