title: Improved diagnostic value of PCR in the diagnosis of female genital tuberculosis leading to infertility.
abstract: Histopathological and mycobacteriological examinations have limited utility in the diagnosis of genital tuberculosis. In this double-blind study, 61 samples, consisting of endometrial aspirates (EAs), endometrial biopsies (EBs) and fluid from the pouch of Douglas (POD), from 25 women suffering from infertility were investigated for the presence of the mpt64 gene of Mycobacterium tuberculosis by PCR and correlated with laparoscopic findings. PCR demonstrated M. tuberculosis DNA in 14 out of 25 patients (56.0 %), compared to one smear with acid-fast bacilli (1.6 %) and two culture-positive samples (3.2 %). The presence of M. tuberculosis DNA was observed in 53.3 % of EBs, 47.6 % of EAs and 16.0 % of POD fluid samples. All patients with laparoscopy suggestive of tuberculosis, 60 % of those with a probable diagnosis and 33 % of those with incidental findings were positive by PCR. However, one EA sample from an infertile patient with normal laparoscopy was also positive. Multiple sampling from different sites and amplification of the mpt64 gene segment by PCR offered increased sensitivity in determining tuberculous aetiology in female infertility.
authors.affiliation: Departments of Microbiology1 and Gynaecology2, All India Institute of Medical Sciences, New Delhi, India 3Molecular Medicine Branch, NIDDK, National Institutes of Health, Bethesda, MD 20892, USA.
authors.forename: N Vijaya
authors.initials: NV
authors.lastname: Bhanu
authors.affiliation: Departments of Microbiology1 and Gynaecology2, All India Institute of Medical Sciences, New Delhi, India 3Molecular Medicine Branch, NIDDK, National Institutes of Health, Bethesda, MD 20892, USA.
authors.forename: Urvashi B
authors.initials: UB
authors.lastname: Singh
authors.affiliation: Departments of Microbiology1 and Gynaecology2, All India Institute of Medical Sciences, New Delhi, India 3Molecular Medicine Branch, NIDDK, National Institutes of Health, Bethesda, MD 20892, USA.
authors.forename: Milan
authors.initials: M
authors.lastname: Chakraborty
authors.affiliation: Departments of Microbiology1 and Gynaecology2, All India Institute of Medical Sciences, New Delhi, India 3Molecular Medicine Branch, NIDDK, National Institutes of Health, Bethesda, MD 20892, USA.
authors.forename: Naga
authors.initials: N
authors.lastname: Suresh
authors.affiliation: Departments of Microbiology1 and Gynaecology2, All India Institute of Medical Sciences, New Delhi, India 3Molecular Medicine Branch, NIDDK, National Institutes of Health, Bethesda, MD 20892, USA.
authors.forename: Jyoti
authors.initials: J
authors.lastname: Arora
authors.affiliation: Departments of Microbiology1 and Gynaecology2, All India Institute of Medical Sciences, New Delhi, India 3Molecular Medicine Branch, NIDDK, National Institutes of Health, Bethesda, MD 20892, USA.
authors.forename: Tanu
authors.initials: T
authors.lastname: Rana
authors.affiliation: Departments of Microbiology1 and Gynaecology2, All India Institute of Medical Sciences, New Delhi, India 3Molecular Medicine Branch, NIDDK, National Institutes of Health, Bethesda, MD 20892, USA.
authors.forename: D
authors.initials: D
authors.lastname: Takkar
authors.affiliation: Departments of Microbiology1 and Gynaecology2, All India Institute of Medical Sciences, New Delhi, India 3Molecular Medicine Branch, NIDDK, National Institutes of Health, Bethesda, MD 20892, USA.
authors.forename: Pradeep
authors.initials: P
authors.lastname: Seth
mesh_terms: D000328:Adult; D000942:Antigens, Bacterial / Q000235:genetics*; D001426:Bacterial Proteins / Q000235:genetics*; D004269:DNA, Bacterial / Q000032:analysis / Q000235:genetics; D004311:Double-Blind Method; D004312:Douglas' Pouch / Q000382:microbiology; D004717:Endometrium / Q000382:microbiology; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000209:etiology*; D010535:Laparoscopy; D009169:Mycobacterium tuberculosis / Q000235:genetics / Q000302:isolation & purification*; D016133:Polymerase Chain Reaction / Q000379:methods*; D012680:Sensitivity and Specificity; D014384:Tuberculosis, Female Genital / Q000150:complications / Q000175:diagnosis* / Q000473:pathology
chemical_list: D000942:Antigens, Bacterial; D001426:Bacterial Proteins; D004269:DNA, Bacterial; C080865:MPB64 protein, Mycobacterium