Genital tuberculosis causes infertility through which mechanism that is MOST refractory to anti-tubercular therapy?

• A Ovarian failure due to granulomatous destruction of follicles
• B Tubal occlusion due to salpingitis and adhesions — bacteriologically cured but anatomically irreversible ✓
• C Asherman syndrome from endometrial ATT-induced scarring
• D Cervical stenosis from tuberculous cervicitis treated with ATT

Explanation

Genital TB most commonly causes infertility through fallopian tube destruction — the tubes are involved in 90–100% of cases. While ATT eliminates the active infection, fibrosis and adhesions from healed granulomata permanently obstruct the tubes and alter the tubo-ovarian anatomy. This anatomical damage does NOT reverse with treatment. Endometrial TB can cause Asherman syndrome (intrauterine adhesions), but this is less common than tubal occlusion. IVF (bypassing the tubes) rather than surgical tuboplasty offers the best fertility option as IVF-ET success rates after tuboplasty in TB are very low.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.