Key questions answered
Q1: Can TB really cause infertility in women?
Yes. Female Genital Tuberculosis (FGTB) is an important and often hidden cause of infertility. It mainly affects the fallopian tubes and the uterine lining (endometrium), making conception difficult. Recent evidence continues to show a strong association between FGTB and infertility.
In India approx. 15 – 20% Infertility cases are due to Female Genital Tuberculosis.
Q2: Which parts of the female reproductive system are commonly affected?
FGTB is a form of extra-pulmonary TB that may involve the fallopian tubes, uterus, ovaries, cervix, and rarely the vagina. The fallopian tubes are the most commonly affected site.
Q3: What are the symptoms?
Many women may have no obvious symptoms, which is why it is often missed. Possible symptoms include:
Difficulty conceiving / infertility
Irregular menstrual cycles
Reduced menstrual flow or absent periods
Chronic pelvic pain
Recurrent miscarriages
Low-grade fever, weight loss, weakness.
Q4: How does it lead to infertility?
TB can cause tubal blockage, adhesions, scarring, and damage to the endometrium, which interferes with fertilization and implantation. This is one of the major mechanisms behind TB-related infertility.
Q5: How is it diagnosed?
Diagnosis may require:
Ultrasound
HSG / tubal patency test
Endometrial biopsy
CBNAAT / molecular tests
Hysteroscopy / laparoscopy
Histopathology
Q6: Is pregnancy possible after treatment?
Yes—if detected early, anti-TB treatment can control the infection and improve fertility outcomes. However, delayed diagnosis may lead to permanent tubal or endometrial damage.
Q7: Can IVF be required?
Yes. If the tubes are severely damaged, IVF may become the best option, especially when the endometrial lining remains reasonably preserved.
Q8: What should women keep in mind?
If pregnancy is not happening despite regular attempts, especially with menstrual irregularities or a past TB history, genital TB must be considered, particularly in TB-endemic countries like India.
Conclusion: Dr S K Arora says that Female genital TB is a hidden but treatable cause of infertility. Early suspicion, timely diagnosis, and complete treatment can preserve both health and motherhood.
Dr. S.K. Arora
Senior Chest Specialist,Consultant,
Ex-Delhi State TB Head, Delhi Government
(Recipient of WHO Award)
