Jirge PR, et al. - Researchers sought to determine the effect of latent genital tuberculosis (GTB) on ovarian reserve in infertile women. Outcomes suggest that in IVF, women with latent GTB have lower ovarian reserves and yield lower numbers of oocytes.

Methods

• From February 2013 to January 2016, researchers compared 431 infertile women diagnosed with latent GTB (Group I) to 453 infertile women without latent GTB (Group II) in this prospective study conducted at Shreyas Hospital, Kolhapur, India, a tertiary referral centre for infertility.
• In both groups, women were 21–38 years of age.
• Infertile women with proven tubal patency but with latent GTB (diagnosed by DNA PCR testing of an endometrial biopsy) comprised Group I.
• Both groups were assessed for day 2–4 anti-Mullerian hormone (AMH) and antral follicle count (AFC).
• Antituberculosis therapy (ATT) was taken by all women with latent GTB.
• In both groups, they noted gonadotropin dosages and oocyte and embryo details for those who underwent IVF.

Results

• Women with latent GTB were younger (29.8 ± 4.4 years vs 30.8 ± 4.5 years; P=0.003).
• Following adjustment for age, Group I demonstrated significantly lower AMH [Median (IQR): 2 (0.9, 4.1) ng/ml vs 2.8 (1.3, 5) ng/ml; P=0.01] and AFC [Median (IQR): 7 (5, 11) vs 8 (5, 14); P < 0.001].
• Women in Group I vs those in Group II yielded fewer oocytes (9.3 ± 7.6 vs 10.9 ± 8.1; P=0.01) post ATT, but showed more grade I embryos transferred (1.1 ± 0.5 vs 0.89 ± 1.0; P=0.001) and a better implantation rate (26.8% vs 17.5%; P=0.004) in IVF.
• A higher pregnancy rate was observed in Group I compared to Group II (51.6% vs 40.5%; P=0.001), through various treatment modalities.
• The role of chance is minimal considering the adequacy of the sample size and use of robust ovarian reserve markers.