Comparison of Effectiveness of Menstrual Blood Sample and Endometrial Biopsy Sample for TB-PCR Test for Detection of Tuberculous Endometritis
Journal Title: Journal of Contemporary Medicine and Dentistry - Year 2016, Vol 4, Issue 2
Abstract
Background: Genital tuberculosis is most common cause of infertility in females. The actual incidence of the genital tuberculosis is not correctly known due to asymptomatic presentation and paucity of investigation. With this objective we tried to investigate effectiveness of menstrual blood and endometrial sample for TB PCR in diagnosis of endometrial tuberculosis in infertile patients Methodology: In 50 patients presented with infertility in whom the inclusion criteria are met, menstrual blood and endometrial aspiration samples were collected on day 1 and day 21 or 22 respectively in normal saline and sent for Real time TB PCR in the Molecular Biology Department of the Yashoda Super Specialty Hospital Hyderabad. The results were noted and ATT was started in cases with positive results for TB PCR with either of the samples or both. Results: The diagnosis of endometrial tuberculosis was confirmed in 12 of 50 (24%) enrolled cases by positive TB PCR (either menstrual blood sample or endometrial biopsy sample or both). Of the 12 positive cases, 10 cases (83.33%) were positive for samples, one case positive for menstrual blood and other case positive for endometrial sample (8.33% each). The sensitivity and specificity of the TB PCR for menstrual blood is 91.67% and 97.33% respectively. These 12 patients were given ATT for 6 months and monitored on monthly basis. 5 of 12 patients (41.66%) conceived. Out of which, 3 are intrauterine viable pregnancies, one is a missed abortion and another one is an ectopic. Conclusion: Genital tuberculosis is not uncommonly encountered in our community. The molecular methods should be employed for its rapid diagnosis and menstrual blood is as effective as endometrial sample for the diagnosis of tuberculous endometritis. Treatment with ATT is to be considered before switching to expensive methods like IVF-ET.
Authors and Affiliations
Sindhoora B, Numi Anjum
Keywords
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