title: Effect of Antitubercular Therapy on Endometrial Function in Infertile Women with Female Genital Tuberculosis.
abstract: OBJECTIVE
  Evaluation of anti-tubercular therapy on endometrium in Female Genital Tuberculosis.
  
  
  METHODS
  Total of 50 women having FGTB on endometrial aspirate (positive AFB, epithelioid granuloma, positive PCR, laparoscopy or hysteroscopy findings) were enrolled. Ultrasound was performed for endometrial thickness, mean resistive index and pulsatility index before and after anti-tubercular therapy (ATT). Diagnostic hysteroscopy was performed for intra-uterine adhesions and to visualise cavity before and after ATT.
  
  
  RESULTS
  Menstrual cycle improved after anti-tubercular therapy (ATT). Endometrial aspirate findings improved with disappearance of AFB, epithelioid granuloma and decrease in PCR (94%vs 33%). After ATT, ultrasound examination of endometrial thickness improved from 7.01±1.48 mm to 7.51±1.48 mm while mean resistive index and pulsatility index decreased from 0.729±0.304 to 0.692±0.399 and 1.180 to 1.138. With ATT, improvement was seen in hysteroscopic findings with normal looking cavity increasing from 18(36%) to 34(72.1%) and pale looking cavity decreasing from 20(42.5%) to 8(16.8%). Before ATT, prevalence of intrauterine adhesions was 62% which decreased to 28.7% after ATT. Improvement was significant only in grade I adhesions from 34% to 2.1%, (p<0.001). There was no improvement in higher grade of intrauterine adhesions with ATT with grade II (6% vs 4.2%) and grade 2a (4% vs 2.1%), grade III being (2% vs 2.1%), grade II a (4% vs 4.2%), grade Va (4% vs 4.2%) and grade Vb (8% vs 10.6%) before and after ATT respectively.
  
  
  CONCLUSIONS
  Early ATT improved menstrual cycle, endometrial thickness and reduced incidence of grade I adhesions. Advanced stages did not show any improvement.
authors.affiliation: Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India. jbsharma2000@gmail.com.
authors.forename: Jai
authors.initials: J
authors.lastname: Bhagwan Sharma
authors.forename: Jayaramaiah
authors.initials: J
authors.lastname: Sneha
authors.forename: Urvashi B
authors.initials: UB
authors.lastname: Singh
authors.forename: Sunesh
authors.initials: S
authors.lastname: Kumar
authors.forename: Kallol
authors.initials: K
authors.lastname: Kumar Roy
authors.forename: Neeta
authors.initials: N
authors.lastname: Singh
authors.forename: Sona
authors.initials: S
authors.lastname: Dharmendra
authors.forename: Ashok
authors.initials: A
authors.lastname: Sharma
authors.forename: Eshani
authors.initials: E
authors.lastname: Sharma
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use*; D004717:Endometrium / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000473:pathology; D005260:Female; D006801:Humans; D015907:Hysteroscopy; D007247:Infertility, Female / Q000209:etiology* / Q000503:physiopathology; D008597:Menstrual Cycle / Q000187:drug effects; D016133:Polymerase Chain Reaction; D011247:Pregnancy; D011446:Prospective Studies; D014384:Tuberculosis, Female Genital / Q000150:complications* / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology; D014463:Ultrasonography; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents