Genital Tuberculosis in Infertility in Delhi
Detection and treatment of genital TB, an under-diagnosed and important cause of infertility in India.
What genital tuberculosis in infertility involves
Genital tuberculosis is a significant and frequently missed cause of infertility in India. It damages the fallopian tubes and the endometrium quietly, often with no symptoms other than difficulty conceiving, irregular periods or recurrent implantation failure.
Dr. Tiwari's award-winning research used Gene Xpert for diagnosing genital tuberculosis in infertility patients, work recognised with the S.N. Bhattacharya Silver Medal at the AOGD Conference — so this is a diagnosis actively looked for here rather than overlooked.
Who this is for
- Unexplained infertility with tubal damage on HSG
- Thin endometrium or Asherman's syndrome with no surgical history
- Repeated implantation failure with good embryos
- History of pulmonary TB or TB contact
Not everything on this list means you need this treatment. The workup comes first, and the recommendation follows from what it shows — not from what was booked before you arrived.
Step by step
Suspicion
Raised by HSG appearances, hysteroscopy findings or a thin, unresponsive endometrium.
Sampling
Endometrial biopsy sent for Gene Xpert, culture and histopathology rather than blood tests alone.
Treatment
A full course of anti-tubercular therapy under supervision, with liver function monitoring.
Post-treatment assessment
Cavity reassessed by hysteroscopy before planning IVF.
Your results, in writing
Whatever the outcome of genital tuberculosis in infertility, you leave each stage with the findings written down — what was done, what was found, what it means, and what the options are from here. Reports are issued the same day wherever the laboratory allows it.
Case study: A thin endometrium with no surgical explanation
29, Uttam Nagar · secondary amenorrhoea · thin endometrium
What she came in with
Periods had become progressively scanty over two years and then stopped, with no history of curettage, surgery or infection. Two IVF cycles elsewhere had been cancelled because the endometrium would not exceed 5 mm.
What the workup showed
Hysteroscopy showed a pale, atrophic endometrium with patchy adhesions and obliterated tubal ostia. An endometrial biopsy sent for Gene Xpert was positive for Mycobacterium tuberculosis; culture confirmed it. Serology, notably, had been negative.
What we did
A full six-month course of anti-tubercular therapy under supervision with monthly liver function monitoring, followed by repeat hysteroscopy and a repeat biopsy to confirm clearance before any treatment was planned.
Outcome
The endometrium recovered to 8.1 mm with a trilaminar pattern. A frozen embryo transfer in the following cycle produced an ongoing pregnancy.
The point of this case
Genital TB is diagnosed on tissue, never on a blood test — her serology was negative while her biopsy was positive. It is one of the most under-diagnosed causes of infertility in India.
Illustrative case. This is a composite of presentations commonly seen in this practice, written for explanation — it is not the record of an identifiable patient, and no individual's details are used. Outcomes vary, and nothing here is a prediction of what will happen in your case.
What is different about having this done here
Diagnosed on tissue, not on an unreliable blood test
Gene Xpert and culture rather than empirical treatment
Over-treatment avoided — ATT is not started on weak evidence
A specific research interest of the consultant
Treated by the consultant, not by a rotating team
Dr. Tiwari performs the scans, the procedure and the follow-up herself, and looks after any pregnancy that results. Over a long treatment course that continuity is the difference between being known and being processed.
- MBBS, MS (Obstetrics & Gynaecology), FNB (Reproductive Medicine)
- Over ten years in reproductive medicine and gynaecological surgery
- Consultations and scans at Mother's Hope, Katwaria Sarai; theatre work at SHE Delhi Hospital, Greater Kailash II
- Itemised costs given in writing before anything begins
Areas we see patients from
Both locations are in South Delhi. Patients travelling from further out have appointments grouped to cut down the number of trips.
Questions about genital tuberculosis in infertility
Is a blood test enough to diagnose genital TB?
No. Serological blood tests for genital TB are unreliable and produce a great many false positives. Diagnosis needs endometrial tissue.
Can I conceive after TB treatment?
If the endometrium recovers, yes, usually with IVF. Where the cavity is badly scarred the outlook is poorer, and we will tell you honestly what the scans show.
Talk it through before you commit
Consultations run for a full hour. Bring any previous reports — they are reviewed properly, not repeated.