Can Tuberculosis Affect Female Fertility

Whenever we hear about tuberculosis (TB), the first impression that it makes in our mind is that it is a disease that causes a lot of cough and affects our lungs. But are only the lungs affected? TB if not treated on time may spread beyond the lungs and can affect organs like the kidneys, bones, brain and even the reproductive system. In fact, genital tuberculosis is one of the lesser-known causes of infertility in both men and women.

Understanding how TB impacts fertility, how it is diagnosed, and what treatment options exist can make a big difference in timely care and recovery.

Understanding Tuberculosis and How It Spreads

Tuberculosis is a bacterial infection caused by Mycobacterium tuberculosis. It is a contagious disease and generally spreads through droplets released when an infected person coughs, sneezes, or speaks. Most people link it with chronic cough and lung damage, but TB can also affect other organs through the bloodstream or lymphatic system. This form of TB is called extrapulmonary TB, which goes beyond the lungs.

When TB affects the reproductive system, it is known as genital or reproductive TB. It does not spread through sexual contact; instead, it travels from another infected area, such as the lungs or lymph nodes, to the reproductive organs.

Factors that increase the risk of developing reproductive TB include:

• A past or untreated episode of pulmonary TB
• Low immunity or poor nutrition
• Living in areas with high TB prevalence
• Recurrent pelvic infections without a clear cause

How TB Affects Female Fertility: Fallopian Tube and Uterine TB

Reproductive TB in women can quietly damage the fallopian tubes, uterus, or ovaries — all vital for natural conception.

Fallopian Tube TB

The fallopian tubes are the most common site of infection. Around 90% of women with genital TB have tubal involvement. The bacteria cause inflammation, scarring, and blockage, preventing eggs from meeting sperm.

This often leads to:

• Blocked tubes
• Ectopic (tubal) pregnancies
• Secondary infertility (after a previous conception)

Unfortunately, these changes can occur silently, without major symptoms.

Uterine TB (Endometrial TB)

When TB affects the uterus, it damages the endometrial lining – the tissue that supports embryo implantation. A thin or scarred endometrium makes it difficult for an embryo to attach and grow, increasing the chances of failed pregnancies or implantation issues.
That is why TB in the uterus can be dangerous if not treated early and can lead to long-term fertility problems.

Common signs include:

• Irregular or absent periods
• Pelvic pain or vaginal discharge
• Recurrent miscarriages or IVF failures

Male Infertility and Tuberculosis: What You Should Know

While reproductive TB is more common in women, it can also affect men, particularly the epididymis, prostate, seminal vesicles, and testes. This can interfere with sperm production, transport, and overall fertility.

How TB Impacts Male Fertility

• Blockages in sperm ducts: The infection can cause scarring or obstruction in the epididymis or vas deferens, preventing sperm from reaching semen.
• Reduced sperm quality: Inflammation and infection can reduce sperm count, motility, and morphology.
• Pain and swelling: Some men experience scrotal pain or swelling due to epididymal TB.

If you are wondering, “My husband has TB, can I get pregnant?”, the answer depends on the type and stage of his TB. Pulmonary TB does not spread sexually, but active genital TB must be treated before planning conception.

Diagnosis of Reproductive TB

Reproductive TB can be difficult to diagnose because symptoms are often vague. A combination of diagnostic tests may be required to confirm the infection.

Diagnosis in Women

1. Pelvic Ultrasound: It helps detect abnormalities in the uterus, ovaries, or fallopian tubes.
2. Hysterosalpingography (HSG): This is an X-ray test that uses a dye to check for fallopian tube blockage.
3. Endometrial Biopsy: A small tissue sample from the uterine lining is taken and examined under a microscope to confirm TB infection.
4. Laparoscopy: A minimally invasive procedure that allows doctors to directly view the pelvic organs and identify adhesions or scarring.
5. PCR Test (Polymerase Chain Reaction): A molecular test that detects TB DNA with high sensitivity. It is useful when routine tests are inconclusive.

Diagnosis in Men

1. Semen Analysis: The gold standard for checking male infertility problems, it evaluates sperm count, its motility and shape. Persistent low counts may raise suspicion of genital TB.
2. Scrotal or Prostate Ultrasound: It helps visualise abscesses or inflammation.
3. Urine and Semen Culture: It checks for the presence of Mycobacterium tuberculosis bacteria.
4. Testicular Biopsy: It is used when other tests are inconclusive, especially in azoospermia men (no sperm in semen).

Treatment Options for TB Patients

Medical Management

Anti-tubercular therapy (ATT) is the primary approach to treating TB. It is a combination of antibiotics taken for 6–9 months, depending on the severity and drug resistance.

The standard regimen includes:

• Isoniazid
• Rifampicin
• Ethambutol
• Pyrazinamide

It is crucial to complete the full course even if symptoms subside early. Do not self-medicate and follow your doctor’s advice. Stopping midway can lead to recurrence or drug resistance.

 

A common question that concerns many individuals is, “Can I get pregnant while taking TB medication?” Doctors usually advise avoiding conception during treatment. TB drugs can sometimes affect liver function or cause side effects, so it is safer to plan pregnancy after completing the course and confirming that the infection has cleared.

 

Fertility Treatments After TB

In certain cases where the infection has caused severe damage to blocked fallopian tubes or there is poor sperm transport, assisted reproductive technologies (ART) can help.

Options include:

• IVF (In Vitro Fertilisation): Eggs are fertilised outside the body, and the resulting embryo is placed in the uterus. It is ideal when the fallopian tubes are blocked, but the uterus is healthy.
• ICSI (Intracytoplasmic Sperm Injection): A single healthy sperm is injected into an egg, useful when sperm count or motility is low due to male TB.
• Surrogacy: It is recommended if the uterine lining is too damaged to sustain pregnancy.

With proper treatment and follow-up, many women successfully conceive after treatment for TB is completed, either naturally or with IVF.

Pregnancy After TB Treatment

Are you wondering if pregnancy is safe after TB?

Yes! A TB patient can get pregnant once the infection is completely cured and the body has recovered. Doctors usually recommend waiting at least 6–12 months post-treatment before attempting conception. This allows time for the reproductive organs to heal and ensures that TB medications are cleared from the system.

With regular monitoring and support from fertility specialists, pregnancy outcomes after TB treatment are mostly positive.

5 Tips for Managing Reproductive Tuberculosis

The following tips can help you manage reproductive TB and support your recovery:

1. Timely diagnosis is important. If you have a history of pulmonary tuberculosis or unexplained infertility, discuss with your doctor about reproductive TB screening.
2. Do not skip or stop TB medication early. Incomplete treatment increases the risk of recurrence.
3. Take a balanced diet packed with protein, vitamins, and antioxidants to strengthen immunity.
4. TB medicines should always be taken under medical supervision. Self-medication can make the problem worse.
5. Post-treatment follow-ups are important for monitoring your health so that if there is a relapse, it can be detected early.

Myths vs Facts About TB and Fertility

Myth ❌	Fact ✅
TB only affects the lungs.	TB can affect any organ, including reproductive organs.
TB spreads through sexual contact.	Genital TB spreads from other infected organs, not sexually.
Women with TB can never get pregnant.	Many women conceive naturally or with fertility treatment after successful TB therapy.
TB medication makes you infertile.	TB medicines do not cause infertility; untreated TB does.
You can try for pregnancy during TB treatment.	It is safer to conceive after treatment completion and medical clearance.

Wrapping it Up!

TB is not limited to the lungs only. If left untreated, it can reach to other organs as well and cause more complications. When it affects reproductive organs, it can cause infertility issues, but it does not mean that your family-building journey comes to an end. With early detection, timely medical intervention and the right care, TB can be treated, and even if it has impacted the fertility, many advanced fertility treatments can be opted for, once the TB treatment is complete.

For more clarity on fertility treatments, feel free to reach out to our experts at Birla Fertility & IVF.