| Pregnancy outcomes after all mode of conception in patients with genital tuberculosis: a systematic review and meta-analysis |
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Dian Tjahjadi1,2, Jenifer Kiem Aviani1, Kevin Dominique Tjandraprawira1, Ida Parwati3, Wiryawan Permadi1,2, Tono Djuwantono1,2, Tin Chiu Li4 |
1Department of Obstetrics and Gynecology, Dr. Hasan Sadikin General Hospital, Faculty of Medicine Uni-versitas Padjadjaran, Indonesia
2Bandung Fertility Center, Limijati Mother and Child Hospital, Bandung, Jawa Barat, Indonesia
3Department of Clinical Pathology, Dr. Hasan Sadikin General Hospital, Faculty of Medicine Universitas Padjadjaran, Bandung, Jawa Barat, Indonesia
4Department of Obstetrics and Gynecology, The Chinese University of Hong Kong, Ma Liu Shui, Hong Kong |
Correspondence:
Dian Tjahjadi,
Email: dian.tjahyadi@unpad.ac.id
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Received: 19 February 2024 • Revised: 11 May 2024 • Accepted: 4 November 2024 |
| Abstract |
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This systematic review and meta-analysis aimed to summarize the pregnancy outcomes of women di-agnosed with genital tuberculosis (GTB) who spontaneously conceived or underwent intrauterine in-semination (IUI) or in vitro fertilization (IVF) after being treated with antitubercular therapy (ATT). Pub-lications from the PubMed, Medline, Embase, Ovid, Scopus, Web of Science, and Google Scholar data-bases were searched from December 20, 2021, to March 5, 2022. The outcomes are presented as pooled averages with 95% confidence intervals. The inconsistency index (I2) test was used to measure the heterogeneity between studies. The certainty of the evidence was assessed using GRADEPro (https://www.gradepro.org/). Of the numerous articles identified, 33 met the inclusion criteria and were included in this systematic review. Generally, there was a significant increase in pregnancy rates among patients who underwent IVF compared with those who underwent ATT (37.9% vs. 23.8%; P=0.02). Con-versely, there was no significant difference in pregnancy rates between patients who underwent IUI and those who conceived spontaneously (18.1% vs. 23.8%; P=0.65). In cases in which no abnormalities were found on hysterosalpingography or hysterolaparoscopy, pregnancy rates were comparable be-tween spontaneous and IVF conceptions (48.4% vs. 49.2%). There were no significant differences in pregnancy or live birth rates between patients with GTB and those with other infertility factors under-going IVF treatment (P>0.05). ATT, which is administered during the early stages of GTB is effective in achieving pregnancy outcomes comparable to IVF. However, in patients with advanced-stage disease, IVF is a superior treatment modality, resulting in increased pregnancy rates. |
| Key Words:
Genital tuberculosis, Anti-tubercular therapy, Laparoscopy, Hysterosalpingography, Polymerase chain reaction, In vitro fertilization, Pregnancy outcome |
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