rifampin and Infertility--Female

Female genital tuberculosis (FGTB) is an infection caused by

Topics: Antitubercular Agents; Female; Humans; Infertility, Female; Isoniazid; Mycobacterium tuberculosis; Pregnancy; Rifampin; Tuberculosis, Female Genital

Recent literature concerning genital tuberculosis in women is reviewed. In Denmark, 25% of the cases are observed in immigrants. The symptoms are non-specific in the form of infertility, metrorrhagia or abdominal pain. Positive culture or specific histology are necessary to establish the diagnosis. Approximately one third of the cases are recognized first during or after operation in connection with laparotomy on suspicion of another condition. Treatment is primarily combined therapy with rifampicin, isoniazide and ethambutol for nine months. If treatment fails or pain persists, total hysterectomy and bilateral salpingectomy are indicated. Bilateral oophorectomy in younger patients with normal ovaries has been discussed. The prognosis as regards survival is good but the patients must be considered to be infertile.

Topics: Denmark; Drug Therapy, Combination; Emigration and Immigration; Ethambutol; Female; Humans; Infertility, Female; Isoniazid; Rifampin; Tuberculosis, Female Genital

To compare modalities for diagnosing genital tuberculosis (GTB) and to assess fertility outcome after antitubercular therapy (ATT).. Infertile women underwent endometrial aspiration (EA) and peritoneal washing (PW) for histopathologic examination, PCR, and acid-fast bacilli (AFB) smear and culture of Mycobacterium tuberculosis; laparoscopy and hysteroscopy were also performed. Women with a positive laboratory test and/or laparoscopic finding classified as definitive/probable received ATT for 6 months.. Of 196 women recruited, 187 underwent laparoscopy. Genital tuberculosis was diagnosed in 118 (60.2%). In 41.3%, EA PCR was positive; PW PCR was positive in 7.6%. The remaining laboratory tests were positive in a small number. Laparoscopy indicated definitive GTB in 9.1% and probable GTB in 37.4%. Among the 118 women treated for GTB, 22.9% conceived without in vitro fertilization; of these women, 74.1% had a positive EA PCR and 59.3% had a positive laparoscopy finding. A quarter of the women received ATT solely on the basis of the PCR result and 31.0% of these women conceived.. No single test can detect all instances of GTB. A combination of tests is needed to increase the detection rate. Treatment given solely on the basis of a positive PCR result can result in conception.

Topics: Adult; Antitubercular Agents; Drug Therapy, Combination; Ethambutol; Female; Fertilization; Humans; Infertility, Female; Isoniazid; Laparoscopy; Polymerase Chain Reaction; Pregnancy; Prospective Studies; Pyrazinamide; Rifampin; Treatment Outcome; Tuberculosis, Female Genital

To evaluate Gene Xpert for diagnosis of Female Genital Tuberculosis (FGTB) as compared to conventional methods.. It was a prospective study conducted over 167 cases of infertile female genital tuberculosis (FGTB) diagnosed on composite reference standard (CRS) (smear for AFB, histopathological evidence of epithelioid granuloma or definite or possible findings of tuberculosis on laparoscopy). All women underwent endometrial biopsy for AFB microscopy, culture, gene Xpert, PCR and histopathology) and laparoscopy and hysteroscopy for diagnosis and prognostication of disease. The results of Gene Xpert were compared with conventional methods in detection of FGTB. All patients were treated with 6 months course of rifampicin (R), isoniazid (H), pyrazinamide (Z) and ethambutol (E) (RHZE for 2 months, RHE for 4 months) using directly observed treatment short course strategy.. Mean age, parity, body mass index and history of contact was 28.3 years, 0.28, 22.9 Kg/m. Gene Xpert is a very useful test to rule in tuberculosis whereas when it is negative it is not a good test to rule out tuberculosis.

Topics: Adult; Endometrium; Female; Humans; Infertility, Female; Mycobacterium tuberculosis; Pregnancy; Prospective Studies; Rifampin; Sensitivity and Specificity; Tuberculosis, Female Genital

Topics: Adult; Antibiotics, Antitubercular; Automation, Laboratory; Bacterial Proteins; Biopsy; DNA-Directed RNA Polymerases; Drug Resistance, Bacterial; Endometrium; Female; Granuloma; Hospitals, University; Humans; India; Infertility, Female; Molecular Typing; Mycobacterium tuberculosis; Real-Time Polymerase Chain Reaction; Rifampin; Sensitivity and Specificity; Tuberculosis, Female Genital; Young Adult

Topics: Adult; Antibiotics, Antitubercular; Antitubercular Agents; Drug Therapy, Combination; Female; Humans; Infertility, Female; Isoniazid; Middle Aged; Pelvic Pain; Pyrazinamide; Retrospective Studies; Rifampin; Tuberculosis, Female Genital; Young Adult

Genital tuberculosis is reported to be a major pelvic factor causing infertility in Indian women and often exists without any apparent signs and symptoms. The role of latent tuberculosis in repeated IVF failure in unexplained infertility is examined. 81 women with unexplained infertility having repeated IVF failure tested for Mycobacterium tuberculosis using PCR, ZN staining and BACTEC-460 culture were selected. Fresh IVF-ET or frozen embryo transfer (FET) was attempted on patients successfully treated with anti-tubercular drugs (ATD). ATD-treated fresh cycles (group A1) and frozen cycles (group B1) were compared to previously failed fresh cycles (group A2) and FET attempts (group B2), respectively. Main outcome measures were gonadotropin required, terminal E2, number of oocytes retrieved, fertilization rate, embryo quality, endometrial thickness and sub-endometrial blood flow (V(max)). Gonadotropin required in group A1 was significantly less as compared to group A2. Number of oocytes retrieved and grade I embryos, endometrial thickness and V(max) were significantly higher in group A1. Endometrial thickness and V(max) were significantly increased in group B1 as compared to B2. The study indicates that latent tuberculosis should be considered in young Indian patients presenting with unexplained infertility with apparently normal pelvic and non-endometrial tubal factors and repeated IVF failure.

Topics: Adult; Antitubercular Agents; Endometrium; Ethambutol; Female; Fertilization; Fertilization in Vitro; Humans; India; Infertility, Female; Polymerase Chain Reaction; Pregnancy; Pregnancy Rate; Pyrazinamide; Rifampin; Tuberculosis, Female Genital

We report 2 patients with pelvic-peritoneal tuberculosis and elevated serum and peritoneal fluid levels of Ca-125. The first was a young and infertile women who had cul-de-sac nodularity and dysmenorrhea. The other was postmenopausal and presented with weight loss and ascites. While a preoperative diagnosis of endometriosis was made in the former, intraperitoneal malignancy was considered in the latter. The diagnosis of pelvic-peritoneal tuberculosis was reached by laparoscopic-directed biopsy in both patients. Serum levels of Ca-125 returned to normal limits following antituberculous drug treatment.

Topics: Adnexal Diseases; Adult; Antigens, Tumor-Associated, Carbohydrate; Ascitic Fluid; Diagnosis, Differential; Ethambutol; Female; Humans; Infertility, Female; Isoniazid; Menopause; Middle Aged; Peritonitis, Tuberculous; Pyrazinamide; Rifampin; Tuberculosis, Female Genital; Uterine Diseases

From 1964 to 1979 we diagnosed 185 new cases of female genital tuberculosis. We report the used diagnostic methods and the changes observed in this time relating to age distribution, subjective symptoms, previous and present specific lesions, clinical and anatomo-pathologic manifestations. We show either the therapeutic schedule, including rifampin, isoniazid and ethambutol, or the surgical treatment indications. With evolution and therapy of pulmonary manifestations, we debate the decrease in genital forms of extrapulmonary tuberculosis and, within the limits of that, the pelviperitonitis disappearance and the reduced incidence of tubal and ovarian inflammations and of genito-pelvic manifestations.

Topics: Amenorrhea; Ethambutol; Female; Humans; Infertility, Female; Isoniazid; Rifampin; Tuberculosis, Female Genital

Topics: Animals; Animals, Newborn; Anti-Bacterial Agents; Antibiotics, Antineoplastic; Atropine; Brain; Chloramphenicol; Cycloheximide; Dactinomycin; Female; Hypothalamus; Infertility, Female; Nerve Tissue Proteins; Ovulation; Procaine; Puromycin; Rats; Rifampin; Sexual Behavior, Animal; Streptomycin; Testosterone