Tuberculosis is often thought of as a lung disease. But for many women, it’s a silent threat to their fertility — and the damage can be irreversible.
Genital Tuberculosis: The Unseen Reproductive Threat
While pulmonary TB gets most of the spotlight, a lesser-known but equally dangerous form exists: genital tuberculosis. This condition sneaks through the bloodstream or lymphatic system, targeting reproductive organs. For many women, it arrives quietly, without any obvious symptoms — until infertility becomes an issue.
According to Dr. Sunita Kapoor, Director and Laboratory Head at City X-Ray and Scan Clinic Pvt. Ltd., genital TB is a significant but underdiagnosed cause of infertility, especially in countries where TB rates remain high. “It’s tricky to diagnose. You often need a combination of tests to confirm it,” she explains.
The numbers paint a grim picture. Vaginal tuberculosis accounts for 1 to 17% of infertility cases globally, depending on the region. The damage can be extensive: blocked fallopian tubes, damaged uterine lining, and even ovarian issues leading to ovulatory failure. For women hoping to conceive, these complications create a painful roadblock.
Why Anti-TB Treatment Isn’t Always Enough
Anti-tuberculosis treatment (ATT) is the standard approach, but it’s not a guaranteed fix for fertility. While ATT can clear the infection, it can’t always undo the structural damage left behind.
Dr. Kapoor highlights this reality. “Even after successful treatment, many women struggle to conceive. The scarring and blockages remain,” she says. That’s because TB leaves a lasting imprint — adhesions, uterine synechiae (scar tissue), and blocked tubes are common outcomes. It’s like trying to grow a garden in soil that’s been scorched.
In medical terms, the endometrial lining — the inner layer of the uterus essential for embryo implantation — often suffers damage that can’t fully regenerate. And when the fallopian tubes are blocked, natural conception becomes nearly impossible.
Diagnostic Challenges: Why It’s Hard to Catch
Genital TB diagnosis isn’t straightforward. The infection often masquerades as other gynecological conditions, leading to misdiagnosis or delays.
Here’s a quick look at the main diagnostic hurdles:
- Non-specific symptoms: Irregular periods, pelvic pain, or unexplained infertility — symptoms that mimic other disorders.
- Hidden infection sites: The bacteria hide deep within the reproductive tissues, making it tough to spot.
- Complex testing: Common tests like ultrasound may miss it. More advanced methods — TB culture or Nucleic Acid Amplification Tests (NAAT) — offer better accuracy but require high-quality samples.
For women facing unexplained infertility, doctors often resort to invasive methods like endometrial biopsy or laparoscopy to get a clear diagnosis. It’s an exhausting, emotionally draining journey — one that too many endure without answers.
Pregnancy Risks and Outcomes for Women with TB
Even when conception happens, genital TB casts a long shadow. The infection increases the risk of complications, including:
- Ectopic pregnancy (where the embryo implants outside the uterus, often in a blocked fallopian tube).
- Miscarriage due to poor endometrial quality.
- Preterm delivery or low birth weight.
Dr. Kapoor emphasizes the need for early detection. “If we catch it early enough — before severe scarring sets in — there’s hope,” she says. But the reality remains that many women only discover they have genital TB after struggling with infertility for years.
The Bigger Picture: Fighting TB on All Fronts
On this World Tuberculosis Day, the focus is usually on lung TB — and rightly so. It’s still one of the deadliest infectious diseases globally. But the lesser-known consequences, like infertility, deserve equal attention.
For women, particularly in high-incidence countries, genital TB isn’t just a medical condition. It’s a life-altering diagnosis. It affects not just physical health but also mental and emotional well-being, relationships, and the deeply personal dream of becoming a mother.
Early diagnosis, advanced testing, and awareness — these are the weapons we need to stop genital TB from stealing more futures.
