Prevalence of Female Genital Tuberculosis in Women Presenting with Infertility: A Cross-Sectional Study in a Tertiary Hospital in Pakistan

Abstract

Objective: To determine the point prevalence of female genital tuberculosis (FGTB) among women presenting with infertility at a tertiary hospital in Pakistan, a country with a high tuberculosis (TB) burden.

Methodology: This investigation utilized a descriptive cross-sectional study conducted at the Department of Obstetrics & Gynaecology, Sandeman Provincial Hospital, Quetta for a period of six months from February 2025 to July 2025. This hospital serves a diverse patient demographic, including a significant number of individuals seeking specialized reproductive health services, Diagnostic tools included clinical assessment, imaging techniques (ultrasonography, hysterosalpingography, hysteroscopy, laparoscopy), histopathological examination of endometrial biopsies, mycobacterial culture, and GeneXpert MTB/RIF assay.

Results: Out of 316 infertile women screened, 13.92% were diagnosed with Female Genital Tuberculosis (FGTB), predominantly presenting with primary infertility. Common symptoms included menstrual irregularities (20.45%), pelvic pain (29.54%), and systemic TB signs (31.81%). Diagnostic modalities varied in effectiveness: histopathology showed the highest positivity (92.68%), followed by laparoscopy (84.09%), culture (79.54%), and GeneXpert (68.75%). HSG revealed tubal abnormalities in 52.77% of cases, while USG and hysteroscopy had lower yields. These findings highlight the burden of FGTB in infertile women and underscore the importance of multimodal diagnostic approaches for accurate detection and timely treatment in tertiary healthcare settings.

Conclusion: Findings are expected to highlight the underdiagnosed nature of FGTB, emphasizing the need for a high index of suspicion, the use of multimodal diagnostic strategies, and timely intervention to reduce the impact of FGTB on reproductive health in Pakistan.