Pune doctors give hope to woman struggling with genital tuberculosis

A Pune couple who had been trying to conceive for seven years were advised to consider adoption due to severe damage caused in the fallopian tubes and endometrium by the womans past Tuberculosis infectionLaparoscopy had revealed fluidfilled fallopian tubes a scarred uterus Ashermanrsquos syndrome and an endometrium too thin to support a pregnancy leaving specialists unable to operate furtherThe fertility specialists at Nova IVF Fertility Lullanagar in Pune suggested PlateletRich Plasma PRP therapy to help regenerate and rejuvenate her endometrium After carefully monitoring the growth of her endometrium for a year IVF was initiated at the right time and the couple successfully conceived and recently welcomed a healthy baby boyA yearlong therapy to grow the endometriumThe patient had been diagnosed with tuberculosis in 2019 and completed the treatment However the infection had caused irreversible damage to her reproductive area Her periods had become scanty an indication that her endometrium was not growing properly yet this wasnrsquot considered anything seriousWhen the couple arrived at the facility in 2023 they faced multiple challenges The wifersquos endometrial thickness measured only 55 mm well below the recommended 7 mm and the husband had slightly compromised semen parametres However the wife had a good number of eggs and the couple had considered this as their last option to have a biological child During the IVF cycle her eggs were successfully retrieved and fertilized with the husbandrsquos sperm resulting in healthy embryos However the critical challenge remained preparing the uterine lining to support pregnancy The medical team at Nova IVF Fertility Pune led by Dr Rupali Tambe spent nearly a year improving her endometrial thicknessDr Tambe added Not just Tuberculosis even sexually transmitted diseases like chlamydia and gonorrhoea can cause longterm reproductive damage even after treatment most often without any symptoms too Many patients heal from the active infection but present years later with infertility as the only symptom The key is early detection and personalised treatmentShe underwent hysteroscopy with metroplasty a procedure to correct the uterus so that it is fit enough to carry on a pregnancy along with PlateletRich Plasma PRP therapy which is clinically proven to improve the lining of the endometrium PRP treatment is used in IVF when a patient has a thin endometrium repeated IVF failures and in a few cases where women have a low reserve of eggsDr Tambe explained Most often in IVF treatments the focus is more on the quality of the gametes however in cases like these we understand that the role of the uterus and endometrium in achieving a pregnancy is equally important The endometrium is like a soil for the seed Just as a farmer waits for the right conditions before sowing we had to ensure the uterus environment is appropriate Even if the seed is good and the soil is not nourishing enough the seed cannot survive After extensive treatment the endometrial thickness reached 67mm the maximum achievable in this case With the right treatment and guidance at the right time most patients can achieve biological parenthood It is extremely important to convey the expectations in the beginning post the diagnosisrdquoA single embryo transfer was performed resulting in a successful pregnancy on the first attempt a healthy one which resulted in a baby boy who is about 2 months oldGenital tuberculosis and achieving pregnancyGenital tuberculosis remains an underdiagnosed presentation of TB with profound effects on reproduction According to recent medical research it is estimated that 5 per cent of women presenting to infertility clinics worldwide have genital TB with the majority aged between 2040 years In India where tuberculosis remains prevalent the condition often goes undetected as it can remain dormant for years after the initial infection heals