Introduction
In India, Africa, and other underdeveloped nations, female genital
tuberculosis (FGTB) is a prevalent cause of infertility; however,
accurate diagnosis is difficult to come by because of paucibacillary
illness. Fifty percent of extrapulmonary tuberculosis(EPTB) cases in
India were found in HIV-positive people, whereas the remaining 15 to
20% were in immune-competent patients. (1,2). Among these, 9% are FGTB
in women’s reproductive age group, adversely affecting their
reproductive health. (1,2)Acid-fast bacilli on endometrial or peritoneal
biopsy, epithelioid granuloma on biopsy, or a positive MTB gene Xpert on
biopsy are all conventional techniques of diagnosis. There is a minimal
chance of success with these, however. Due to the high rate of false
positive results, a positive polymerase chain reaction (PCR) cannot be
relied upon as diagnostic evidence on its own. When conventional TB
tests are negative for a patient, diagnostic laparoscopy and
hysteroscopy may often reveal the presence of TB lesions. FGTB
significantly affects women’s chance of conception by distorting
anatomically and pathophysiologically reproductive organs. (3–5) The
presence of characteristic caseous granuloma, with or without Langerhans
giant cells, is indicative of genital tuberculosis when exhibited on
histology. (6) The crucial histologic finding to diagnose endometrial
tuberculosis is the presence of epithelioid cell granulomas in different
stages and multinucleated giant
cells of both Langhans and foreign body type and lymphoid aggregate.
(7,8) The ability to see acid-fast bacilli(AFB) and the discovery of
caseation are two other findings. Those who identify these
characteristics on endometrial biopsy are thus included in the study
population. In addition, C cartridge-based nucleic acid amplification
tests (CBNAAT/ Xpert MTB/RIF assay) and liquid culture by mycobacterial
growth indicator tube (MGIT) with phenotypic drug sensitivity testing
(DST) are WHO-approved rapid diagnostic tests. (6,9)
Several observations made during laparoscopy and hysteroscopy have been
mentioned in the published research relevant to FGTB.(6,10–12). In
addition, treatment with anti-tubercular medication is started once that
has been determined to be necessary. However, there is no such paper
that discusses the results of laparoscopic and hysteroscopic
examinations in female patients who have been diagnosed with
subfertility and endometrial tuberculosis.