Journal of Reproductive Medicine Gynaecology & Obstetrics Category: Medical Type: Research Article
Effect of Female Genital Tubercular Involvement on Anti-Mullerian Hormone Secretion in Latent Genital Tuberculosis Affected Women
- Abira Datta1, Subhankar Chowdhury2, Rajib Gon Chowdhury3, Basudev Bhattyacharya2, Siddhartha Chatterjee4*
- 1 Department Of Biochemistry And Endocrinology, Institute Of Post Graduate Medical Education & Research, Calcutta Fertility Mission, Kolkata, India
- 2 Department Of Biochemistry And Endocrinology, Institute Of Post Graduate Medical Education & Research, Kolkata, India
- 3 Department Of Reproductive Medicine, Calcutta Fertility Mission, Kolkata, India
- 4 Department Of Biochemistry And Endocrinology, Calcutta Fertility Mission, 21, Bondel Road, Kolkata - 700019, Kolkata, India
*Corresponding Author:
Siddhartha ChatterjeeDepartment Of Biochemistry And Endocrinology, Calcutta Fertility Mission, 21, Bondel Road, Kolkata - 700019, Kolkata, India
Tel:+91 9830387875,
Email:sidchat54@gmail.com
Received Date: Jan 29, 2019 Accepted Date: Feb 22, 2019 Published Date: Mar 08, 2019
Abstract
Background
Tubercular involvement of female genital tract is probably becoming more and more of latent form now a days. This involvement is difficult to diagnose by standard test like culture, animal inoculation and histopathology. The diagnostic dilemma is due to paucity of bacillary number in genital tract. Polymerase Chain Reaction (PCR) is fast emerging as the preferred diagnostic tool for identification of tubercular assault in female genital tract. The ovarian affection of tubercular bacilli has been investigated by some investigators but the hormonal affection requires extensive investigation. Evaluation of Anti-Mullerian Hormone (AMH) as a marker of ovarian function in those cases might have some roles.
Methods
700 patients that presented with symptoms of clinically confirmed infertility at reproductive medicine unit of Calcutta fertility mission during the months of December 2015 to December 2017 were recruited for in vitro fertilization. 414 of these patients fulfilled the required inclusion criteria were advised for Polymerase Chain Reaction (PCR) along with routine ovarian function check-up for estimating the hormone assay. A group of 108 fertile subjects were included as control group.
Results
Of the 414 subjects, 230 (55.55%) were PCR positive and 184 (44.44%) subjects were PCR negative. It has been observed that AMH concentration is much lower in PCR positive group than PCR negative and fertile group with statistical significance.
Conclusion
We concluded that tubercular involvement of genital tract may lower the AMH secretion as well as ovarian reserve causing infertility.
Keywords
ABBREVIATIONS
PCR: Polymerase Chain Reaction
AMH: Anti Mullerian Hormone
ATD: Anti Tubercular Drug
IVF: In Vitro Fertilization
ORT: Ovarian Reserve Test
INTRODUCTION
MATERIALS AND METHODS
Study design
Selection criteria
Aim
Consent
Collection of sample
PCR (Polymerase Chain Reaction) study
AMH (Anti-Müllerian Hormone) assay
Multiplex-PCR
AMH assay
Statistical analysis
Ethical approval
RESULT



|
Infertile |
Fertile |
||
Characteristics |
Range |
Mean |
Range |
Mean |
Age (Years) |
20-39 |
31.25 |
24-38 |
29.26 |
Body mass index (kg/m2) |
18.3-32.4 |
24.32 |
18.3-32.4 |
22.79 |
Normal cycle (day) |
25-35 |
31.14 |
25-35 |
29.68 |
|
Mean |
Median |
Min |
Max |
IQR |
PCR negative (n=184, 44.44%) |
6.531 |
5.400 |
1.980 |
22.850 |
4.625 |
PCR positive (n=230, 55.55%) |
0.963 |
0.880 |
0.010 |
0.880 |
0.890 |
Fertile group (n=108) |
5.795 |
5.190 |
1.250 |
15.360 |
3.137 |
Age (years) |
Infertile |
Normal control group |
P-value of Mann-Whitney test |
|||
Median AMH concentration (ng/ml) in percent with 95% CI |
Median AMH concentration (ng/ml) in percent with 95% CI |
Infertile PCR negative - normal |
Infertile PCR positive - normal |
Infertile PCR negative - Infertile PCR positive |
||
PCR positive |
PCR negative |
|||||
20-24 |
114.0 (91.5-134) |
466.5 (211-772) |
659.0 (578-970) |
0.515 |
0.000 |
0.000 |
25-29 |
115.5 (84.5-152) |
536.0 (479-792) |
630.0 (459-790) |
|||
30-34 |
100.0 (82.5-119.5) |
646.5 (543-804) |
413.5 (350-538) |
|||
35-39 |
65.0 (43.5-76.5) |
375.0 (277-550) |
491.0 (390-620) |
Infertile |
Normal control or Fertile group |
||
No. of Patients (%) |
No. of Patients (%) |
||
PCR - Positive |
PCR - Negative |
||
20 – 24 |
4 (4) |
10 (11) |
9 (17) |
25 – 29 |
20 (18) |
31 (33) |
21 (39) |
30 – 34 |
47 (42) |
40 (43) |
18 (33) |
35 – 39 |
40 (36) |
12 (13) |
6 (11) |
DISCUSSION
CONCLUSION
CONFLICT OF INTEREST
FUNDING
ACKNOWLEDGEMENT
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Citation:Datta A, Chowdhury S, Chowdhury RG, Bhattyacharya B, Chatterjee S (2019) Effect of Female Genital Tubercular Involvement on Anti-Mullerian Hormone Secretion in Latent Genital Tuberculosis Affected Women. J Reprod Med Gynecol Obstet 4: 018.
Copyright: © 2019 Abira Datta, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
