Clinical Outcomes of In Vitro Fertilization and Embryo Transfer in Patients with Previous History of Pelvic Tuberculosis

Kim, S H; Kim, M H; Jee, B C; Jung, B J; Suh, C S; Choi, Y M; Kim, J K; Moon, S Y; Lee, J Y

Abstract

One of the most common presentation of pelvic tuberculosis is infertility due to the extensive tubal destruction not amenable to the reconstructive tubal surgery. As the prognosis for fertility in infertile patients with the healed pelvic tuberculosis is very poor, in vitro fertilization and embryo transfer (IVF-ET) remains as the only therapeutic option in these patients. The objective of this retrospective clinical study was to evaluate the effects of previous pelvic tuberculous lesions on the outcomes of IVF-ET. Infertile patients with tubal factor only were classified into two groups : Group I - 72 cycles of IVF-ET in 55 patients with previous history of pelvic tuberculosis which was diagnosed by hysterosalpingography (HSG), diagnostic laparoscopy, endometrial biopsy, and culture, and Group II - 177 cycles in 150 patients without history of pelvic tuberculosis. Groups I and II were similar in clinical characteristics of patients such as age, duration of infertility, and basal serum FSH level. There were no significant differences in the outcomes of IVF-ET including peak serum E2 level, numbers of oocytes retrieved and embryos transferred, fertilization rate, and implantation rate between two groups. The clinical and ongoing pregnancy rates per cycle (19.4%, 18.1%) and per patient (25.5%, 23.6%) in Group I did not differ from those in Group II (28.2%, 20.3%; 33.3%, 24.0%). The abortion rate in Group I (7.1%) was lower but without significance, compared with Group II (28.0%). These data suggest that previous pelvic tuberculous lesions may have no adverse effects on the outcomes of IVF-ET. In conclusion, IVF-ET should be considered as the only realistic option of treatment modality in infertile patients with previous history of pelvic tuberculosis.