Role of anti-tubercular treatment in vitro fertilization (IVF)

Abstract

Objective

To evaluate the role of anti-tubercular treatment (ATT) in vitro fertilization (IVF).

Design

Retrospective analysis.

Methods

A retrospective study was performed in 45 women suffering from infertility with a diagnosis of thin endometrium, history of repeated IVF failure, recurrent miscarriages or hysteroscopic or laparoscopic adhesiolysis in 4 years duration. Based on composite reference standard (CRS), in all females, Akt 4 Kit (combination of four medicines – Isoniazid 300 mg, rifampicin 450 mg, ethambutol 800 mg and pyrazinamide 750 mg) was started for 2 months with supportive medicines followed by AKT 2 (combination of two medicines – Isoniazid 300 mg and rifampicin 450 mg) for 4 months. Fertility treatment was started after 2 months of Akt 4 medication. In all cases, frozen embryo transfer was planned with tab estradiol valerate 6–8 mg in divided doses followed by endometrial thickness scanning. In all cases, embryo transfer was planned when endometrial thickness >8 mm in transvaginal scanning. The efficacy of ATT in above cases was evaluated by assessing the endometrium thickness before embryo transfer, pregnancy rates and clinical pregnancy rates.

Results

There was no significant difference regarding demographic variables, egg reserve, sperm parameters, number of embryos transferred and embryo quality in all cases. Out of 45 cases, the pregnancy was positive in 31 cases (Pregnancy rate – 68.8 %). The clinical pregnancy rate was 64.4 % (29/45).

Conclusion

There is a significant role of anti-tubercular treatment (ATT) in infertility in case of thin endometrium not responsive to medications, repeated IVF failure, recurrent miscarriages or hysteroscopic or laparoscopic adhesiolysis. It improved the endometrial thickness, pregnancy rate and the clinical pregnancy rate in IVF. But further studies are needed with large sample size to collaborate our findings.