A 28-year-old woman with genital tuberculosis is being treated with anti-TB therapy for 9 months and is found to be infertile. Hysteroscopy reveals intrauterine synechiae. The expected fertility outcome after hysteroscopic adhesiolysis is:

• A Poor reproductive outcomes; live birth rates remain low (10–20%) due to persistent endometrial damage ✓
• B Normal conception rates comparable to the general population
• C Resolution of infertility in >80% of cases with anti-TB drugs alone
• D Surrogacy is contraindicated; IVF with own uterus is the preferred option

Explanation

Genital tuberculosis causes severe, often irreversible endometrial destruction through caseous necrosis, replacement fibrosis, and intracavitary adhesions (Asherman-like syndrome). Even after adequate anti-TB treatment and hysteroscopic adhesiolysis, the endometrium is functionally compromised — thin, poorly responsive to estrogen, with loss of endometrial glandular architecture. Published series report live birth rates of only 10–20% after all interventions. Surrogacy (gestational carrier) is actually the preferred route for women with TB-destroyed endometrium who wish to have a biological child.

Reference: Shaw's Textbook of Gynaecology, 17th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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