Adverse pregnancy outcomes after in vitro fertilization due to undiagnosed urogenital tuberculosis and proposed screening algorithm for patients from tuberculosis-endemic countries

Stephanie E McLaughlin; Surabhi B Vora; E Chandler Church; Christopher Spitters; Angela Thyer; Sylvia LaCourse; Christopher N Herndon

doi:10.1016/j.xfre.2022.07.008

Adverse pregnancy outcomes after in vitro fertilization due to undiagnosed urogenital tuberculosis and proposed screening algorithm for patients from tuberculosis-endemic countries

F S Rep. 2022 Aug 5;3(3):285-291. doi: 10.1016/j.xfre.2022.07.008. eCollection 2022 Sep.

Authors

Stephanie E McLaughlin^{1

2}, Surabhi B Vora³, E Chandler Church^{1

4}, Christopher Spitters^{1

2

5}, Angela Thyer⁶, Sylvia LaCourse^{1

7}, Christopher N Herndon⁸

Affiliations

¹ Department of Medicine, Division of Infectious Diseases, University of Washington.
² Public Health Seattle and King County.
³ Department of Pediatrics, Division of Infectious Diseases, Seattle Children's Hospital.
⁴ Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, Washington.
⁵ Snohomish Health District.
⁶ Seattle Reproductive Medicine.
⁷ Department of Global Health, University of Washington, Washington.
⁸ Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Washington, Seattle, Washington.

PMID: 36212574
DOI: 10.1016/j.xfre.2022.07.008

Abstract

Objective: To report 2 cases of adverse pregnancy outcomes due to delayed diagnosis of urogenital tuberculosis and propose a screening algorithm for patients from tuberculosis-endemic countries.

Design: Case report.

Setting: Academic medical center.

Patients: Two patients with delayed diagnosis of urogenital tuberculosis leading to a fetal loss and a preterm delivery of an infant with congenital tuberculosis.

Interventions: Endometrial biopsy, acid-fast bacilli culture of urine, and endometrium.

Main outcome measures: Pregnancy outcomes.

Results: Fetal loss at 19 weeks and preterm delivery of an infant with congenital tuberculosis before urogenital tuberculosis treatment.

Conclusions: Patients who are at risk of urogenital tuberculosis should be screened in advance of infertility treatment to potentially prevent adverse pregnancy outcomes.

Keywords: Urogenital tuberculosis; congenital tuberculosis; female genital tuberculosis, IVF; infertility.