P-729 The cumulative clinical pregnancy and live birth rates of IVF in women treated for genital tuberculosis are similar to those in other infertility etiologies
Authors: Jindal U.N , Kumar S 
Published: June 2022

Abstract

Study question
Is cumulative clinical pregnancy rate (CPR) and live birth rate (LBR) in infertile patients with treated genital tuberculosis similar to other infertility etiologies undergoing IVF?

Summary answer
There is no significant difference in cumulative CPR and LBR in women adequately treated for genital tuberculosis undergoing IVF compared to other etiology of infertility.

What is known already
Female genital tuberculosis (FGTB) is an important cause of infertility in high tuberculosis prevalent countries. The uterine endometrial environment is an important cradle for embryo development. Once violated with infection, the damage to the endometrial blood flow and uterine cavity morphology is likely to be irreversible leading to infertility even after cure with anti-tuberculosis therapy (ATT). Adequate treatment of FGTB involves medical therapy with ATT and surgical treatment of hydrosalpinges and endometrial adhesions. The cumulative CPR and LBR are reported to be lower in the treated endometrial tuberculosis than in non-tuberculosis infertile patients undergoing IVF.

Study design, size, duration
This is a retrospective analysis of women who underwent IVF with self-oocytes over a period of 4 years from 2015 to 2018. All patients were divided into two groups as:
Group-1: All women treated with ATT for FGTB before IVF with all presentations including women who underwent surgery for hydrosalpinges or intrauterine synechiae except with severe intrauterine adhesions and unfit for embryo transfer (ET)
Group-2: Patients undergoing IVF other infertility etiologies.

Participants/materials, setting, methods
Women undergoing ovum pickup along with subsequent fresh and frozen embryo transfer attempts until attained a live birth or all the embryos were used.
Exclusion criteria:

Main results and the role of chance
A total of 948 women underwent OPU during the study period.
171 were excluded from analysis for following reasons:
Total of 775 women were included for analysis and results are summarized as:
The mean number of embryos per OPU was 7.04 in Group-1 while 6.97 in Group-2. A total of 195 ET procedures were done in Group-1 while 1035 in Group-2. The mean number of ET procedures required for one clinical pregnancy in Group-1 was 3.15 and 2.81 in Group-2.The mean number of ET procedures required for one live birth in Group-1 was 3.42 and 3.02 in Group-2. CPR per ET procedure in Group-I was 31.79% while 35.55% in Group-2. All these differences were statistically insignificant.

Limitations, reasons for caution
The FGTB has a wide spectrum of presentation from a very early sub-clinical disease to an advanced stage with pelvic organ damage. The prognosis of IVF varies with the extent of disease. This study analyzed overall result while sub categories of FGTB were not analyzed.

Wider implications of the findings
Infertility after ATT treated FGTB has good IVF outcome. IVF outcome in these patients need to be studied based upon the extent of damage. We recommend undertaking an early IVF with good hope of live birth in ATT treated FGTB.

Trial registration number
Not applicable