Genital TB spreading infertility among women

It all started with mild abdominal pain and irregular vaginal bleeding for 30-year-old Isha Ravi. Failing to heed the symptoms, the problem aggravated and Isha began to suffer from irregular periods, chest pain and pain in the abdomen. Despite umpteen attempts by Isha and her husband, the couple failed to conceive.

It was a moment of shock for Isha and her husband, when the doctor revealed that she was an acute patient of "Genital Tuberculosis". An endometrial biopsy was recommended to test the lining of her uterus which clearly stated that she was infertile and the problem aggravated due to her not paying heed to the disease at the initial level.

Though doctors clearly told her that she won't be able to conceive ever, they have suggested to Isha to start the medication to prevent any sort of complication.Doctors say that nearly 90 percent of women with genital tuberculosis are diagnosed in the 15-40 years age group. Infertility on account of genital tuberculosis is 60-80 percent. Doctors say that usually TB of the uterus and fallopian tubes is the cause for infertility but in the case of Isha the "endometrium lining" of her uterus was damaged.

A thick, healthy lining of the uterus, known as the endometrium is necessary for a healthy menstrual cycle and pregnancy.Recent studies have concluded that till a decade ago only 10 percent of the total tuberculosis patients suffered from genital tuberculosis, but the percentage has now increased to 30 percent due to ignoring the disease in the initial stages and lack of awareness.

"The tuberculosis starts affecting the genitals once the 'mycobacterium tuberculosis' enters the human body. Initially it does not affect and remains silent as most of us can fight off the infection. However, later these latent bacilli can get reactivated, and then spread throughout the body through the blood stream. It is only when it lodges and infects the genital tract, that TB bacteria can cause genital TB and can cause infertility," Rajesh Chawla, senior consultant, respiratory medicine at Delhi-based Indraprastha Apollo Hospital said on Sunday.

In males, genital tuberculosis causes tuberculous epididymo-orchitis, blocking the ureteral passage, as a result of which the man becomes azoospermic - lack of sperms - and is not able to ejaculate during intercourse because the tract is blocked. "While in the woman the TB causes infection of the uterus, fallopian tubes; this infection can often be silent, and may not cause any symptoms or signs at all. It later on leads to infertility.

The problems may also include bleeding discharge, ulcers, among other symptoms," Chawla added.A recent study by the Indian Journal of Medical Research through its survey stated that the number of women with genital tuberculosis in India has increased to 30 per cent in 2015 from 19 per cent in 2011.

The report also stated that Saudi Arabia has the second highest number of genital tuberculosis patients with 21 percent.According t0 Vikas Maurya, senior consultant, respiratory medicine and Interventional pulmonology at Delhi-based BLK Super Speciality Hospital, "Genital TB is a matter of great concern because the symptoms don't appear easily and by the time it's realized it already leaves an impact on the fertility of humans."

By Rupesh Dutta